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What are the complications of aortic stenosis ?

What are the complications of aortic stenosis ? • Left ventricular failure indicates poor prognosis unless the valve is replaced. • Sudden death occurs in 10-20% of adults and I% of children. It has been rarely documented to occur without prior symptoms. It is an uncommon event -probably <1% per year. • Arrhythmias and conduction abnormalities include ventricular arrhythmias (more common than supraventricular arrhythmias) and heart block (may occur because of calcification of conducting tissues). • Systemic embolization is caused by disintegration of the aortic valve apparatus or by concomitant aortic atheroma. • Infective endocarditis (in 10% of cases) should be considered when these patients present with unexplained illness. • Haemolytic anaemia.

What is the mechanism of syncope in aortic stenosis ?

What is the mechanism of syncope in aortic stenosis ?  • The left ventricle is suddenly unable to contract (transient electro-mechanical dissociation) against the stenosed valve.  • Cardiac arrhythmias (bradycardia, ventricular tachycardia or fibrillation).  • Marked peripheral vasodilatation without a concomitant increase in cardiac out-put. particularly after exercise.

Does the loudness of the murmur reflect the severity of the aortic stenosis ?

Does the loudness of the murmur reflect the severity of the aortic stenosis ?  No, the loudness of the murmur is related more to the cardiac output and the systolic turbulence surrounding the valve than to the severity of the stenosis. Thus, a loud murmur may be associated with trivial stenosis and, in severe heart failure, the mur-mur may be soft because of decreased flow across the valve from the diminished cardiac output.

Mention some causes of aortic stenosis

Mention some causes of aortic stenosis  • Under the age of 60 years: rheumatic, congenital.   • Between 60 and 75 years: calcified bicuspid aortic valve, especially in men.   • Over the age of 75 years: degenerative calcification.

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