Aortic Stenosis:

Causes: Rf, biscuspid valve, calcification, cogential

Hx: SOB (gas exchange, pulmonary vein pressure)
! (demand " force against valve, supply of
muscle)
Syncope (during exertion " inability to O,
vasodilation, and cerebral perfusion)
#ethargy (energy used on breathing)
o/e: Slo$ rising, lo$ volume pulse
%S& " radiate carotids, louder in expir, soft '
nd
(S
(yperdynamic apex beat
)arro$ pulse pressure
Ix: *R + ,R-. !ulmonary oedema
%cho " %f- /ortic area- 0radient
%01 #BBB- #2(
Bloods " 3BS 4 56%
Rx: Surgery /2R " tissue-metal
,/27
7ndications1 0rad 89:mm(g
/rea ;<=:cm
'

#231
RR
>isplaced /B
Basal crac?les
@
rd
(S
Aortic Regur.:
Causes: Rf, 7%, dissection, syphilis, marfans, an?= sond=
Hx: #231 SOB
ough (pin? frothy sputum)
!)>
Orthopnoea
o/e: %arly high pitch >&, louder sitting for$ard, in
expiration,
over # sternal edge=
A2!, $ide pulse pressure

ollapsing pulse (orriganBs pulse)
>e &ussetBs sign ((ead nodding)
&ullerBs sign (!ulsations of uvula)
,raubeBs sign (0unshot femorals)
>uroCieCBs sign (>4S heard in femorals)
DuincheBs sign (ap= Bed pulsation)
Ix: %01 #2(
%cho1 %f- 0rad=
*R
Rx: &edical1 afterload (diuretics- /%)
Surgical1 /2R if evidence of #23
Mitral Stenosis:
Causes: Rf, calcification, R/, S#%, arcinoid
Hx: #231 SOB
ough (pin? frothy sputum)
!)>
Orthopneia
!
#O
#ethargy
(aemoptysis
o/e: ool peripheries
#o$ volume pulse
./f irreg= irrerg= rhythm
&alar flush
A2!
5ndisplaced tapping /B
#o$+pitched mid >&
#ouder in # lateral position in expiration
Opening snap of &2, heard after S'
Ix: %01 /f, !+mitrale
%cho
*R
Rx: &edical if not severe (Rx (3 and /f)
Surgical1 if pulm (,, symptoms severe
!ulm (,1
R ventricular heave
A2!
#oud !'
/scities
Oedema
Mitral Regur.:
Causes: R3, 7(>, &2 prolapse, 7%, papillary rupture
Hx: Sx of #231 SOB
ough
!)>
Orthopnea
o/e: ollapsing pulse
A2!
>isplaced /B
!S& E axilla, louder in expiration
Soft S<
Obliteration of S'
(4-+ murmur at lo$er # sternal edge, tricuspid regur=
" louder on inspiration)
Ix: %0
%cho
*R
Rx: &edical if symptoms mild
Surgical " if sign= symptoms- #23