Valvular Heart Disease

Aortic Stenosis (AS)

Etiology

  • Calcific: predominant cause in Pts >70 y; risk factors include HTN, ↑ chol., ESRD
  • Congenital (ie, bicuspid AoV w/ premature calcification): cause in 50% of Pts <70 y
  • Rheumatic heart disease (AS usually accompanied by AR and MV disease)
  • AS mimickers: subvalvular (HCMP, subAo membrane) or supravalvular stenosis

Clinical manifestations (usually indicates AVA <1 cm2 or concomitant CAD)

  • Angina: ↑ O2 demand (hypertrophy) + ↓ O2 supply (↓ cor perfusion pressure) ± CAD
  • Syncope (exertional): peripheral vasodil. w/ fixed CO → ↓