Cardiology 5 — Aortic Valve Disease

Lecture Outline

I. Aortic Stenosis
A. Causes
B. Pathophysiology
C. Symptoms
D. Exam
1. Murmur
2. Other exam findings
3. Studies
E. Treatment
II. Aortic Regurgitation
A. Causes
B. Pathophysiology
C. Symptoms
D. Exam
1. Murmur
2. Other exam findings
E. Treatment

Aortic Stenosis

1. What are the most common causes of aortic stenosis?

2. What are the 3 primary symptoms of aortic stenosis?

3. What are the characteristics of the murmur of aortic stenosis?

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4. What peripheral pulse finding is associated with aortic stenosis?

5. What two measurements are used to determine the severity of aortic stenosis?

6. How is aortic stenosis treated?

Quick Review

7. Which heart valves should blood be flowing through during systole?

8. What are the systolic heart murmurs?

9. What heart valves should blood be flowing through during diastole?

10. What are the diastolic heart murmurs?

11. What are the three primary symptoms seen in aortic stenosis?

12. What symptom of aortic stenosis is associated with the worst prognosis?

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Aortic Regurgitation

13. What causes chronic aortic regurgitation?

14. What are the symptoms of acute aortic regurgitation?

15. What are the characteristics of the murmur of aortic regurgitation?

16. What peripheral signs are classically associated with aortic regurgitation?

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End of Session Quiz

1. What conditions place patients at the highest risk for the development of infective endocarditis, and
therefore require antibiotic prophylaxis during high risk procedures?

2. What procedures place patients at the highest risk for bacteremia, and therefore would be an indication for
endocarditis prophylaxis in the appropriate patient?

3. In a patient who requires endocarditis prophylaxis, what antibiotic regimen is appropriate?

4. What lesion is associated with the following exam findings?

Crescendo-decrescendo systolic murmur best heard in the 2nd-3rd right

interspace close to the sternum
High-pitched diastolic murmur associate with a widened pulse pressure

Water-hammer pulse

Pulsus parvus et tardus

de Musset’s sign

Traube’s sign

5. What conditions can cause acute aortic regurgitation?

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6. What is the preferred medical management of chronic aortic regurgitation?

7. What is the preferred medical management of aortic stenosis?

8. What two echocardiographic findings indicate critical aortic stenosis?

9. Which type of prosthetic valve would generally be recommended to a 78-year-old patient with aortic
stenosis?

10. With what valvular lesion may an Austin Flint murmur be heard?

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