Dr. Usman's Cardiology Notes

A 40 years old female presented with chest pain and light headedness on exertion. Examination showed B.P of 110/90 mmHg, delayed carotid upstroke, double apical impulse, Ejection Systolic Murmur radiating to carotid. ECG is remarkable for Left Ventricular Hypertrophy. Echocardiography revealed critical aortic stenosis with Aortic Valve Area of < 1cm 2 , Mean Gradient of 30 mmHg and Left Ventricular Ejection Fraction of 60 %.   a) How would you differentiate between valvular and sub-valvular aortic stenosis? b) What are the indications for cardiac catheterization and how will you calculate Aortic Valve Area? c) What is paradoxical low flow severe Aortic Stenosis and give two reasons for it? d) What are the class I indications of Aortic Valve Replacement? e) What is the most likely reason for severe Aortic Stenosis in this woman? Answers: a.       Clinical findings of valvular aortic stenosis are presence of ejection click and soft A2. In subvalvular AS ...