Bicuspid aortic stenosis history and symptoms: Difference between revisions
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{{Bicuspid aortic stenosis}} | {{Bicuspid aortic stenosis}} | ||
{{CMG}} | {{CMG}} {{AE}} {{USAMA}} | ||
==Overview== | ==Overview== | ||
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==Symptoms== | ==Symptoms== | ||
Symptoms may not develop until adolescence (in later adulthood with acquired [[aortic stenosis]]) and include:<ref name="pmid18820172">{{cite journal| author=Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD et al.| title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=Circulation | year= 2008 | volume= 118 | issue= 15 | pages= e523-661 | pmid=18820172 | doi=10.1161/CIRCULATIONAHA.108.190748 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18820172 }} </ref> <ref name="pmid20424150">{{cite journal| author=Rajani R, Rimington H, Chambers JB| title=Treadmill exercise in apparently asymptomatic patients with moderate or severe aortic stenosis: relationship between cardiac index and revealed symptoms. | journal=Heart | year= 2010 | volume= 96 | issue= 9 | pages= 689-95 | pmid=20424150 | doi=10.1136/hrt.2009.181644 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20424150 }} </ref><ref name="pmid11559673">{{cite journal| author=Amato MC, Moffa PJ, Werner KE, Ramires JA| title=Treatment decision in asymptomatic aortic valve stenosis: role of exercise testing. | journal=Heart | year= 2001 | volume= 86 | issue= 4 | pages= 381-6 | pmid=11559673 | doi= | pmc=1729928 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11559673 }} </ref><ref name="pmid11029480">{{cite journal| author=Das P, Pocock C, Chambers J| title=The patient with a systolic murmur: severe aortic stenosis may be missed during cardiovascular examination. | journal=QJM | year= 2000 | volume= 93 | issue= 10 | pages= 685-8 | pmid=11029480 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11029480 }} </ref> | Symptoms may not develop until adolescence (in later adulthood with acquired [[aortic stenosis]]) and include:<ref name="pmid18820172">{{cite journal| author=Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD et al.| title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=Circulation | year= 2008 | volume= 118 | issue= 15 | pages= e523-661 | pmid=18820172 | doi=10.1161/CIRCULATIONAHA.108.190748 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18820172 }} </ref><ref name="pmid20424150">{{cite journal| author=Rajani R, Rimington H, Chambers JB| title=Treadmill exercise in apparently asymptomatic patients with moderate or severe aortic stenosis: relationship between cardiac index and revealed symptoms. | journal=Heart | year= 2010 | volume= 96 | issue= 9 | pages= 689-95 | pmid=20424150 | doi=10.1136/hrt.2009.181644 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20424150 }} </ref><ref name="pmid11559673">{{cite journal| author=Amato MC, Moffa PJ, Werner KE, Ramires JA| title=Treatment decision in asymptomatic aortic valve stenosis: role of exercise testing. | journal=Heart | year= 2001 | volume= 86 | issue= 4 | pages= 381-6 | pmid=11559673 | doi= | pmc=1729928 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11559673 }} </ref><ref name="pmid11029480">{{cite journal| author=Das P, Pocock C, Chambers J| title=The patient with a systolic murmur: severe aortic stenosis may be missed during cardiovascular examination. | journal=QJM | year= 2000 | volume= 93 | issue= 10 | pages= 685-8 | pmid=11029480 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11029480 }} </ref><ref name="pmid6020739">{{cite journal| author=Mody MR, Nadas AS, Bernhard WF| title=Aortic stenosis in infants. | journal=N Engl J Med | year= 1967 | volume= 276 | issue= 15 | pages= 832-8 | pmid=6020739 | doi=10.1056/NEJM196704132761503 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6020739 }} </ref><ref name="pmid13505014">{{cite journal| author=ONGLEY PA, NADAS AS, PAUL MH, RUDOLPH AM, STARKEY GW| title=Aortic stenosis in infants and children. | journal=Pediatrics | year= 1958 | volume= 21 | issue= 2 | pages= 207-21 | pmid=13505014 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13505014 }} </ref> | ||
#[[Dyspnea on exertion]] | #[[Dyspnea on exertion]] | ||
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#[[Orthopnoea]] | #[[Orthopnoea]] | ||
#[[Pedal edema]] in case of [[right heart failure]] | #[[Pedal edema]] in case of [[right heart failure]] | ||
#[[Fever]] may be present in presence of [[ | #[[Fever]] may be present in presence of [[endocarditis]] | ||
#[[Aortic aneurysm]]s or [[aortic dissection]]s as [[aortic root]] enlargement from cystic medial changes occur commonly in these patients which may present as '''tearing chest pain radiating to upper back'''. | #[[Aortic aneurysm]]s or [[aortic dissection]]s as [[aortic root]] enlargement from cystic medial changes occur commonly in these patients which may present as '''tearing chest pain radiating to upper back'''. | ||
Latest revision as of 12:47, 2 April 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
Bicuspid aortic stenosis is often undiagnosed until later in life when the person develops symptomatic aortic stenosis. Aortic stenosis occurs in this condition usually in patients in their 40s or 50s, an average of 10 years earlier than can occur in people with congenitally normal aortic valves. 30% of cases are diagnosed in adolescence.
Symptoms
Symptoms may not develop until adolescence (in later adulthood with acquired aortic stenosis) and include:[1][2][3][4][5][6]
- Dyspnea on exertion
- Exertional dizziness or syncope
- Exertional angina
- Palpitations
- Fatigue
- Orthopnoea
- Pedal edema in case of right heart failure
- Fever may be present in presence of endocarditis
- Aortic aneurysms or aortic dissections as aortic root enlargement from cystic medial changes occur commonly in these patients which may present as tearing chest pain radiating to upper back.
References
- ↑ Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172.
- ↑ Rajani R, Rimington H, Chambers JB (2010). "Treadmill exercise in apparently asymptomatic patients with moderate or severe aortic stenosis: relationship between cardiac index and revealed symptoms". Heart. 96 (9): 689–95. doi:10.1136/hrt.2009.181644. PMID 20424150.
- ↑ Amato MC, Moffa PJ, Werner KE, Ramires JA (2001). "Treatment decision in asymptomatic aortic valve stenosis: role of exercise testing". Heart. 86 (4): 381–6. PMC 1729928. PMID 11559673.
- ↑ Das P, Pocock C, Chambers J (2000). "The patient with a systolic murmur: severe aortic stenosis may be missed during cardiovascular examination". QJM. 93 (10): 685–8. PMID 11029480.
- ↑ Mody MR, Nadas AS, Bernhard WF (1967). "Aortic stenosis in infants". N Engl J Med. 276 (15): 832–8. doi:10.1056/NEJM196704132761503. PMID 6020739.
- ↑ ONGLEY PA, NADAS AS, PAUL MH, RUDOLPH AM, STARKEY GW (1958). "Aortic stenosis in infants and children". Pediatrics. 21 (2): 207–21. PMID 13505014.