Question

hello, please help to answer

A patient with aortic stenosis has come into the clinic with dyspnea, orthopnea, cough, and chest pain. Explain in your own words why these particular symptoms develop in people with aortic stenosis. 1. Write th exact question you are directing (you may pick one from the five listed). 2. Start with defining the disease. 3. Share symptoms, diagnosis procedure, and treatment. 4. Share personal experience, if you have any with family/friend/patient who may have had this.

Answer 1

Explanation of symptoms.

Angina - improper oxygen supply due to hypertrophy of left ventricle. Exertion Al dyspnoea is because on exercise or heavy work left ventricle is unable to increase its output to meet the oxygen demand of myocardium and the body causing an increased afterload and increased filling pressure.

Cough, orthopnea and paroxysmal nocturnal dyspnoea due to failure of left ventricle.

2. Definition of the disease.

Narrowing of the aortic valve causing fixed luminal obstruction to the outflow of left ventricle.

3. Symptoms include exertional dyspnea, Angina pectoris, cough, hemoptysis, orthopnea, PND due to left heart failure (LHF*)

Exertional syncope due to low cardiac output, sudden death.

Diagnosis -

Inspection of the chest - apex beat may be normal or may be displaced beyond 5th intercostal space and outside mid clavicular line.

Palpation. - palpable left ventricular thrust may be noted.

Displaced apex beat as mentioned above.

Tender hepatomegaly in case of failure of right heart.

Percussion - cardiac dullness.

Auscultation - mid systolic ejection murmur can be heard. And lung creptitions can also be heard due to LHF.

Investigations -

ECG - shows left atrial Nd ventricular hypertrophy.

Chest x ray - lateral view to see calcification of aortic valve.

Echocardiography - left ventricular hypertrophy, calcified aortic valve, can be seen also decreased left ventricle function.

Treatment -

Mainly surgical  

Ballon valvuloplasty in case of congenital aortic stenosis.

Valve replacement - patients with AS and pressure gradient exceeding 60mm across the valve should undergo valve replacement.

Question 4 is for the student to answer.