Kathryn Statham The ECHO features of aortic stenosis can be explained through the natural history and the pathophysiology of the disease. Degenerative calcific AS is a progressive valvular disease. It is characterised by A long latent period when the patient is asymptomatic despite progressive obstruction of the valve Once symptoms occur, there is a rapid Read more about 1. Assessment of Severity of AS : 2D assessments[…]
Kathryn Statham Quantitative Assessment of AS Peak AV jet velocity (m/sec) Mean AV gradient (mmHg) Valve area by continuity equation (cm2) Dimensionless severity index (dimensionless) 1. Pressure Gradients Stenosis results in a pressure gradient. The pressure gradient is high before an obstruction and low distal to the obstruction. The greater the stenosis the greater the Read more about 2. Assessment of Severity of AS : Quantitative assessment[…]
Kathryn Statham Aortic stenosis It is the most common valvular heart disease in developed countries It’s prevalence is increasing with our ageing population It is found in 3% of patients > 75 yrs It is the most common valve disease requiring surgical intervention in developed countries. TAVI is increasingly the treatment of choice for severe Read more about Causes of Aortic Stenosis[…]
Kathryn Statham, Genevieve Carbonatto AR is rarely physiological. If it is present then a cause needs to be found. ECHO is used to determine Aetiology Estimate severity Assess chronicity This is done first by imaging the heart with 2D echo and looking at: valves aortic root size LV cavity size (chronic vs acute) LV wall Read more about Assessment of aortic regurgitation[…]
Kathryn Statham , Genevieve Carbonatto Congenitally abnormal valves Bicuspid Unicuspid Quadricuspid Bicuspid valves (BAV) have been classified in many different ways. An easy classification looks at the number of cusps, the presence of raphes and the position and symmetry of cusps. A raphe refers to a conjoined area of two underdeveloped leaflets turning into Read more about 3. Causes of Aortic regurgitation : Congenitally abnormal valves[…]
Kathryn Statham , Genevieve Carbonatto 1. Aortic root dilatation loss of leaflet coaptation hypertension connective tissue disorders (Marfans etc) 2. Loss of commissural support Aortic dissection VSD Aortic trauma Aortic root dilatation Aortic root dilatation can cause loss of leaflet coaptation as in the clips below Loss of commissural support Loss of commissural support Read more about 2. Causes of Aortic regurgitation : Aortic root dilatation and Loss of commissural support[…]
Kathryn Statham , Genevieve Carbonatto Valve destruction and degeneration sclerosis/stenosis infective endocarditis rheumatic heart disease aortic valve prolapse. 1. Valve sclerosis / stenosis 2 -3 % of people will develop severe AS after the age of 75. If the leaflets become thick and calcified they are poorly mobile causing them to close incompletely Read more about 1. Causes of Aortic regurgitation : Valve destruction and degeneration[…]
Kathryn Statham , Genevieve Carbonatto Epidemiology The prevalence of chronic AR is 5 -10% (mainly mild AR) The prevalence of moderate to severe AR 0.5 – 2.7% AR increases with age It peaks in the 4th to 6th decade of life It is more common in men than in women A formal ECHO evaluation is Read more about Causes of Aortic regurgitation: Summary[…]
Genevieve Carbonatto The aortic valve is the centrepiece of the heart It lies between the PV, the TV and the MV It is wedged between the opening of the mitral and tricuspid valves The normal aortic valve consists of 3 equally sized semilunar leaflets or cusps. The leaflets form a 3 pronged crown-like structure. The Read more about Aortic valve anatomy[…]