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Structural Heart Disease
Structural Heart Disease

Aortic Stenosis



    • Causes of Aortic Stenosis

    • Calcific degeneration
    • Rheumatic heart disease
    • Congenital bicuspid aortic valve
    • Infective endocarditis


  • Aortic stenosis manifests as an ejection (mid) systolic murmur best heard over the base of the heart, associated with narrowed pulse pressure and reduced intensity of S2.
    • Signs of Aortic Stenosis

    • Peripheral Signs

    • Anacrotic pulse - small volume pulse with a slow upstroke and a notched wave on the upstroke
    • Narrow pulse pressure
    • Central Signs

    • Aortic thrill
    • Pressure-loaded apex beat - forceful and sustained impulses
    • Soft second heart sound (S2)
    • Ejection systolic murmur - heard best over the aortic area in expiration
    • Signs of Complications

    • Evidence of left ventricular failure - pulsus alternans, pulmonary crepitations
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