Aortic Stenosis - Severe #2


Aortic stenosis is a narrowing of the aortic valve opening that blocks (obstructs) blood flow from the left ventricle to the aorta. The most common cause in people younger than 70 is a birth defect that affects the valve. In people over 70, the most common cause is thickening of the valve cusps (aortic sclerosis). People may have chest tightness, feel short of breath, or faint.

Doctors usually base the diagnosis on a characteristic heart murmur heard through a stethoscope and on results of echocardiography. People see their doctors regularly so their condition can be monitored, and people with symptoms may undergo replacement of the valve. The aortic valve is in the opening between the left ventricle and the aorta. The aortic valve opens as the left ventricle contracts to pump blood into the aorta. If a disorder causes the valve flaps to become thick and stiff, the valve opening is narrowed (stenosis). Sometimes the stiffened valve also fails to close completely and aortic regurgitation develops.

In Severe Aortic Stenosis there is a diamond shaped systolic murmur which lasts throughout systole. The murmur is loud and higher pitched than the murmur of mild aortic stenosis. It is caused by calcification of the aortic valve leaflets. There is a fourth heart sound heard in late diastole (just before the first heart sound). This is caused by the increased left ventricular wall thickness and stiffness.

S1 is normal. S2 is louder than normal. In fact, you are hearing only the accentuated pulmonic component of S2 due to heart failure on the left side. The aortic ejection click heard in mild cases of valvular aortic stenosis is gone.  
Aortic Stenosis - Severe #2

Maneuver: Sitting
Position: Aortic
Chestpiece: Diaphragm


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