aortic stenosis


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stenosis

 [stĕ-no´sis] (pl. steno´ses)
an abnormal narrowing or contraction of a body passage or opening; called also arctation, coarctation, and stricture.
aortic stenosis obstruction to the outflow of blood from the left ventricle into the aorta; in the majority of adult cases the etiology is degenerative calcific disease of the valve.
hypertrophic subaortic stenosis (idiopathic hypertrophic subaortic stenosis) a cardiomyopathy of unknown cause, in which the left ventricle is hypertrophied and the cavity is small; it is marked by obstruction to left ventricular outflow.
mitral stenosis a narrowing of the left atrioventricular orifice (mitral valve) due to inflammation and scarring; the cause is almost always rheumatic heart disease. Normally the leaflets open with each pulsation of the heart, allowing blood to flow from the left atrium into the left ventricle, and close as the ventricle fills again so that they prevent a backward flow of blood. In mitral stenosis there is a resultant increase of pressure in the pulmonary artery and hypertrophy of the left ventricle. The usual treatment is surgical replacement of the valve.
pulmonary stenosis (PS) narrowing of the opening between the pulmonary artery and the right ventricle.
pyloric stenosis see pyloric stenosis.
renal artery stenosis narrowing of one or both renal arteries by atherosclerosis or by fibrous dysplasia or hyperplasia, so that renal function is impaired (see ischemic nephropathy). Increased renin release by the affected kidney causes renovascular hypertension, and bilateral stenosis may result in chronic renal failure.
spinal stenosis narrowing of the vertebral canal, nerve root canals, or intervertebral foramina of the lumbar spine, caused by encroachment of bone upon the space; symptoms are caused by compression of the cauda equina and include pain, paresthesias, and neurogenic claudication. The condition may be either congenital or due to spinal degeneration.
subaortic stenosis aortic stenosis due to an obstructive lesion in the left ventricle below the aortic valve, causing a pressure gradient across the obstruction within the ventricle. See also idiopathic hypertrophic subaortic stenosis.
subglottic stenosis stenosis of the trachea below the glottis. A congenital form results in neonatal stridor or laryngotracheitis, often requiring tracheotomy but resolving with age. An acquired form is caused by repeated intubations.
tracheal stenosis scarring of the trachea with narrowing, usually as a result of injury from an artificial airway or trauma.
tricuspid stenosis (TS) narrowing or stricture of the tricuspid orifice of the heart, a condition often seen in patients with severe congestive heart failure, usually the result of volume overload and pulmonary hypertension with right ventricular and tricuspid annular dilation.

a·or·tic ste·no·sis

pathologic narrowing of the aortic valve orifice.

aortic stenosis

A condition characterised by narrowing of the aortic annulus due to degeneration and calcification of the valve leaflets; AS is more common and occurs earlier in patients with underlying valve defects (e.g., bicuspid valves). Aortic stenosis in previously normal valves develops after age 60 and is associated with HTN and hypercholesterolaemia.

Aetiology
Rheumatic fever, congenital heart disease, idiopathic sclerosis.
 
Physical examination
Systolic ejection murmur radiating to the neck. In mild stenosis, the murmur peaks early in systole and is often associated with a thrill; with increased severity, the murmur peaks progressively later in systole and may become softer as cardiac output decreases.

Clinical findings
Angina, syncope, congestive heart failure (CHF).
 
Haemodynamics
Chronic stenosis leads to LV enlargement and CHF. Pressure gradient is related to valve area 6mm Hg at 2cm2 and 26 mm Hg at 1cm2, but 105 mm Hg at 0.5 cm2.

Diagnosis
Doppler echocardiography indicates increased flow rates and decreased total flow; catheterisation; coronary angiography.
 
Management
If asymptomatic, none needed except for prophylactic antibiotics to cover for infective endocarditis; valve replacement surgery; balloon valvotomy is only palliative.

aortic stenosis

Cardiology Narrowing of the aortic annulus caused by degeneration and calcification of the valve leaflets; AS is more common and occurs earlier in Pts with underlying valve defects–eg, bicuspid valves; AS in previously normal valves develops after age 60 and is associated with HTN and hypercholesterolemia Etiology Rheumatic fever, congenital heart disease, idiopathic sclerosis Clinical Angina, syncope, CHF Hemodynamics Chronic stenosis leads to LV enlargement, CHF Examination Systolic ejection murmur radiating to the neck; in mild stenosis, the murmur peaks early in systole and is often associated with a thrill; with ↑ severity the murmur peaks progressively later in systole, and may become softer as cardiac output ↓ Diagnosis Doppler echocardiography indicates ↑ flow rates and ↓ total flow; catheterization, coronary angiography Management If asymptomatic, none needed except for prophylactic antibiotics to cover for infective endocarditis; valve replacement surgery; balloon valvotomy is only palliative. Cf Aortic regurgitation, Pulmonary stenosis.

a·or·tic sten·o·sis

(ā-ōr'tik stĕ-nō'sis)
Pathologic narrowing of the aortic valve orifice, blocking blood flow from the left ventricle, thus decreasing cardiac output.

aortic stenosis

Narrowing of the aortic valve of the heart.

Aortic stenosis

A stiffening of the artery which carries blood from the heart to the body.

Patient discussion about aortic stenosis

Q. How does alcohol affect someone who has been diagnosed with aortic valve stenosis? My brother has been diagnosed with aortic valve stenosis and also is a smoker and does drink alcohol on the weekends. He knows that he should stop smoking but what about the effects of alcohol? Does this also contribute to his stenosis?

A. Alcohol changes blood pressure and speed of the heart- that is not a good idea if you have an Aortic stenosis. Could probably makes things worst. I would avoid alcohol… but he should ask GP.

Q. Why does Aortic stenosis causes an enlarged heart? My father was recently diagnosed as suffering from enlarged heart due to his Aortic stenosis. what is the connection between those to conditions? As far as I understand that aortic stenosis mean that the aortic valve is too small not too large...

A. there are several explanations for the enlargement of the heart that occurs due to Aortic stenosis. the most reasonable is that the mechanical power that the heart uses makes it bigger. it easy to see it here: http://www.marvistavet.com/assets/images/aortic_stenosis.gif
this is called Left Ventricular Hypertrophy or LVH in abbreviations.
this is a classic LVH E.C.G.
http://www.frca.co.uk/images_main/resources/ECG/ECGresource39.jpg

More discussions about aortic stenosis
References in periodicals archive ?
Balloon valvuloplasty for congenital aortic stenosis: Multi-center safety and efficacy outcome assessment.
Targeted therapy to prevent progression of calcific aortic stenosis. Circulation.
Current management of calcific aortic stenosis. Circ Res.
Although, this patient exhibited eccentric left ventricular hypertrophy, such alteration is recognized as an uncommon finding in subjects diagnosed with aortic stenosis, which usually causes concentric hypertrophy secondary to the increased resistance imposed by the ventricular outflow tract obstruction.
found that aortic root dilatation occurs irrespective of the presence and severity of aortic stenosis in BAV.
Aortic balloon valvuloplasty is a safe and effective procedure for aortic stenosis win pediatric population.
Also in 2016, the FDA gave the go-ahead to the PARTNER III trial, which will examine TAVR in symptomatic aortic stenosis patients at low risk of surgical complications.
[7.] Logeais Y, Langanay T, Roussin R, Leguerrier A, Rioux C, Chaperon J: Surgery for aortic stenosis in elderly patients.
Aortic stenosis was defined as follows: mild (aortic jet velocity of 2.0-2.9 m/s and a peak systolic gradient and a mean gradient of <36 mmHg and <20 mmHg, resp.), moderate (aortic jet velocity of 3.0-4.0 m/s and a peak systolic gradient and a mean gradient of 36-64 mmHg and 20-40 mmHg, resp.), and severe (aortic jet velocity of >4 m/s and a peak systolic gradient and a mean gradient of >64 mmHg and >40 mmHg, resp.).
Krishnaswami, "Diabetes and hypercholesterolemia among patients with calcific aortic stenosis," Journal of Chronic Diseases, vol.
Most cases of aortic stenosis develop when calcium collects around the valve.
Aortic Stenosis (AS) is most common valvular heart disease in developed countries.