By Amr E. Abbas
With the arrival of much less invasive remedies for aortic stenosis together with percutaneous and apical alternative, extra sufferers are being provided this know-how. As such, picking the genuine severity of aortic stenosis is turning into paramount. Many scientific situations happen the place the realm and gradient estimates of severity don't fit. This ebook will current case by way of case examples of other sufferers with a wide selection of aortic stenosis. it is going to help cardiologists in opting for sufferers with actual aortic stenosis who may gain advantage from valve substitute. it is going to additionally spotlight the function and introduction of latest expertise because the function of CTA, MRI, and 3D echo for analysis and TAVR and mini surgical procedure for treatment. The viewers will diversity from scientific cardiologists, imaging cardiologists and interventionalists alike.
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Additional resources for Aortic Stenosis: Case-Based Diagnosis and Therapy
292. 5. Harvey WP. Cardiac pearls. Newton: Laennec; 1993. p. 345. 6. Munt B, et al. Physical examination in valvular aortic stenosis: correlation with stenosis severity and prediction of clinical outcome. Am Heart J. 1999;137(2):298–306. 7. Carabello BA. Evaluation and management of patients with aortic stenosis. Circulation. 2002;105(15):1746–50. 6 cm2/m2, and/or a maximum transaortic velocity (AVVel) >4 m/s with or without symptoms. Surgical or transcatheter aortic valve replacement for symptomatic, severe AS results in significant improvement in survival and quality of life across a spectrum of surgical risk profiles.
The intensity of the murmur is related to the volume and velocity of transaortic flow, while the pitch is related to the transaortic pressure gradient and valve area. Both the intensity and pitch are related to sound conductivity through the pericardium, lungs, and chest wall. In general, a louder murmur with a higher pitch is associated with increased severity. However, in situations with decreased transaortic flow, with normal or decreased ejection fraction, or with COPD, obesity, or effusion, a low pitch murmur with low intensity may be auscultated in the presence of severe AS.
2005;111:920–5. Park SJ, Enriquez-Sarano M, Choi JO, Lee SC, Park SW, Kim DK, Jeon ES, Oh JK, Chang SA. Hemodynamic patterns for symptomatic presentations of severe aortic stenosis. JACC: Card Imaging. 2013;6:137–46. Monin JL, Lancellotti P, Monchi M, Lim P, Weiss E, Pierard L, Gueret P. Circulation. 2009;120:69–75. Lim P, Monin JL, Monchi M, Garot J, Pasquet A, Hittinger L, Vanoverschelde JL, Carayon A, Gueret P. Predictors of outcome in patients with severe aortic stenosis and normal left ventricular function: role of B-type natriuretic peptide.