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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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