|
 | Presentation
 | Triad of angina, syncope, esp. w/ exertion, dyspnea |
| CHF due to LV failure |
|
| PE
| Vitals: narrow pulse pressure |
| CV: systolic murmur LSB, radation to carotids,
Decreased S2, S4, PMI |
| Lungs: auscultate |
| Extremities: decreased peripheral pulses |
|
| DDx
| Aortic stenosis |
| MI |
| Vasovagal syncope |
| TIA |
| PE |
| Seiszure disorder |
|
| Laboratory
| CXR (dilation of ascending aorta, calcification,
pulmonary congestion) |
| EKG (LVH, ST-T changes, atrial fib) |
| Echo (critical valve size <0.5 cm, critical gradient >
50) |
| Cath if symptomatic |
| Cardiac enzymes, CBC |
| Holter monitor +/- |
|
| Treatment
| Medical: Avoid strenuous activity, diruetics, low
Na+ if CHF, Dig if A Fib
 | ACE-i is contraindicated? |
| Antibiotic prophylaxis for surgery/dental procedures |
|
| Surgery: valvuloplasty or replacement (better
outcome) |
|
|
