Aortic Stenosis
July 1st, 2020
Overview
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
Causes of Aortic Stenosis
- Calcific degeneration
- Rheumatic heart disease
- Congenital bicuspid aortic valve
- Infective endocarditis
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