Aortic stenosis
Background
Clinical Features
- Dyspnea, CP, syncope
- Once symptoms present mean surival is 2-3yr
- ejection systolic murmur radiating to carotids
- Pulsus parvus et tardus, slow to rise and late peaking
- Narrowed pulse pressure
- Soft 2nd heart sound
Diagnosis
- Echo
Differential Diagnosis
Valvular Emergencies
Treatment
- Admission
- Avoid BBs, CCBs
- Afterload reduction is controversial
- Consider cards consult
- AS + A-fib = emergency
- Consider emergent cardioversion
- Pulm edema
- Diuretics, intubation if necessary
- Extreme caution with use of nitrates/vasodilators
See Also
Source
Tintinalli