Aortic Stenosis
N C Joshi
Consultant Pediatrician, Nanavati Hospital, Mumbai, India
First Created: 01/08/2001
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Aortic Stenosis Types
- Valvular: bicuspid valve
- Subvalvular: Membrane (discrete), Long tunnel, IHSS
Anatomical types of aortic stenosis (Figure 1)
- normal
- valvular stenosis
- supravalvular stenosis
- discrete subaortic stenosis
- IHSS
M:F=4:1
Aortic Stenosis - Clinical Manifestations
- Most are asymptomatic
- Severe cases: CHF, exertional chest pain, syncope
Physical Examination:
- Acyanotic
- Narrow pulse pressure. Higher BP in the right arm than the left in supravalvular AS
- Systolic thrill with murmur at RUSB, suprasternal notch and over the carotid arteries
- Early ejection systolic click with valvular AS
Figure 2: Cardiac findings of aortic valve stenosis. Abnormal sounds are indicated in black. The systolic thrill may be present in areas with dots.
Aortic Stenosis - Investigations
ECG: Normal even in severe cases or LVH with strain
Chest X-ray: Heart size > normal with dilated ascending aorta
Aortic Stenosis - Treatment
- Aortic valve commissurotomy: When peak gradient >50 mmHg or valve area <0.5 cm2/m2
- Membrane excision
- Myectomy - For Tunnel sub aortic stenosis & IHSS
- Fabric patch- Supravalvular
N C Joshi
Aortic Stenosis
Aortic Stenosis
01/08/2001
01/08/2001
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Contributor Information and Disclosures
N C Joshi
Consultant Pediatrician, Nanavati Hospital, Mumbai, India
First Created: 01/08/2001