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{| class="wikitable"
|+
! rowspan="2" |{{fontcolor|#FFF|Disease}}
! colspan="5" |{{fontcolor|#FFF|Clinical features}}
|-
| colspan="4" |{{fontcolor|#FFF|'''Signs'''}}
|{{fontcolor|#FFF|'''Symptoms'''}}
|-
| text-align: center;" |[[Aortic stenosis]]
| colspan="4" text-align: center;" |
===Vitals===
 
*[[Narrow pulse pressure]]: The systolic pressure may decrease and narrow [[pulse pressure]] may be present.<ref name="pmid15710699">{{cite journal| author=Bermejo J| title=The effects of hypertension on aortic valve stenosis. | journal=Heart | year= 2005 | volume= 91 | issue= 3 | pages= 280-2 | pmid=15710699 | doi=10.1136/hrt.2004.041749 | pmc=1768786 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15710699  }}</ref><ref>{{Cite journal
| author = [[J. BERGERON]], [[W. H. ABELMANN]], [[H. VAZQUEZ-MILAN]] & [[L. B. ELLIS]]
| title = Aortic stenosis; clinical manifestations and course of the disease; review of one hundred proved cases
| journal = [[A.M.A. archives of internal medicine]]
| volume = 94
| issue = 6
| pages = 911–924
| year = 1954
| month = December
| pmid = 13217489
}}</ref>
 
*[[Pulsus parvus et tardus]].<ref name="pmid90321642">{{cite journal |author=Etchells E, Bell C, Robb K |title=Does this patient have an abnormal systolic murmur? |journal=[[JAMA : the Journal of the American Medical Association]] |volume=277 |issue=7 |pages=564–71 |year=1997 |month=February |pmid=9032164 |doi= |url= |accessdate=2012-04-09}}</ref>
*[[Pulsus bisferiens]] with mixed [[aortic stenosis]] and [[aortic regurgitation]].<ref name="pmid134718182">{{cite journal| author=FLEMING PR| title=The mechanism of the pulsus bisferiens. | journal=Br Heart J | year= 1957 | volume= 19 | issue= 4 | pages= 519-24 | pmid=13471818 | doi= | pmc=503962 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13471818  }}</ref>
*Delayed carotid upstroke (apical-carotid delay) is present. <ref>{{Cite journal
| author = [[Blase A. Carabello]] & [[Walter J. Paulus]]
| title = Aortic stenosis
| journal = [[Lancet (London, England)]]
| volume = 373
| issue = 9667
| pages = 956–966
| year = 2009
| month = March
| doi = 10.1016/S0140-6736(09)60211-7
| pmid = 19232707
}}</ref>
*[[Pulsus alternans]].<ref>{{Cite journal
| author = [[R. H. Swanton]], [[B. S. Jenkins]], [[I. A. Brooksby]] & [[M. M. Webb-Peploe]]
| title = An analysis of pulsus alternans in aortic stenosis
| journal = [[European journal of cardiology]]
| volume = 4
| issue = 1
| pages = 39–47
| year = 1976
| month = March
| pmid = 1261578
}}</ref>
 
===Heart===
 
*laterally displaced [[apical impulse]].<ref>{{Cite journal
| author = [[S. J. Galloway]], [[W. J. Casarella]] & [[P. M. Shimkin]]
| title = Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis
| journal = [[Radiology]]
| volume = 113
| issue = 1
| pages = 11–15
| year = 1974
| month = October
| doi = 10.1148/113.1.11
| pmid = 4547644
}}</ref><ref name="pmid204358422">{{cite journal| author=Maganti K, Rigolin VH, Sarano ME, Bonow RO| title=Valvular heart disease: diagnosis and management. | journal=Mayo Clin Proc | year= 2010 | volume= 85 | issue= 5 | pages= 483-500 | pmid=20435842 | doi=10.4065/mcp.2009.0706 | pmc=2861980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20435842  }}</ref>
 
*[[thrill|Systolic thrill]] at the right second intercostal space, in the jugular notch and along the [[carotid arteries]].<ref>{{Cite journal
| author = [[S. J. Galloway]], [[W. J. Casarella]] & [[P. M. Shimkin]]
| title = Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis
| journal = [[Radiology]]
| volume = 113
| issue = 1
| pages = 11–15
| year = 1974
| month = October
| doi = 10.1148/113.1.11
| pmid = 4547644
}}</ref>
*paradoxical splitting of S2 is present with [[A2]] taking place after P2..<ref>{{Cite journal
| author = [[Ilias Maglogiannis]], [[Euripidis Loukis]], [[Elias Zafiropoulos]] & [[Antonis Stasis]]
| title = Support Vectors Machine-based identification of heart valve diseases using heart sounds
| journal = [[Computer methods and programs in biomedicine]]
| volume = 95
| issue = 1
| pages = 47–61
| year = 2009
| month = July
| doi = 10.1016/j.cmpb.2009.01.003
| pmid = 19269056
}}</ref><ref name="pmid204358422" /><ref>{{Cite journal
| author = [[Chance M. Witt]], [[William R. Miranda]] & [[Darrell B. Newman]]
| title = The maverick heart sound
| journal = [[Heart (British Cardiac Society)]]
| volume = 102
| issue = 13
| pages = 1008
| year = 2016
| month = July
| doi = 10.1136/heartjnl-2015-309131
| pmid = 26919867
}}</ref>
*[[S4]], [[S3]].
*the murmur is Crescendo-decrescendo type of [[ejection systolic murmur]].<ref>{{Cite journal
| author = [[Atsuko Furukawa]], [[Yukio Abe]], [[Makoto Ito]], [[Chiharu Tanaka]], [[Kazato Ito]], [[Ryushi Komatsu]], [[Kazuo Haze]], [[Takahiko Naruko]], [[Minoru Yoshiyama]] & [[Junichi Yoshikawa]]
| title = Prediction of aortic stenosis-related events in patients with systolic ejection murmur using pocket-sized echocardiography
| journal = [[Journal of cardiology]]
| volume = 69
| issue = 1
| pages = 189–194
| year = 2017
| month = January
| doi = 10.1016/j.jjcc.2016.02.021
| pmid = 27012751
}}</ref><ref name="pmid204358422" />
 
===Lungs===
 
*In a patient with [[Aortic Stenosis]], [[Rales|Pulmonary rales]] may be present when [[congestive heart failure]] has developed.<ref>{{Cite journal
| author = [[Lennart van Gils]], [[Marie-Annick Clavel]], [[Mara Vollema]], [[Victoria Delgado]], [[Tamim Nazif]], [[Ernest Spitzer]], [[Rebecca Hahn]], [[Jeroen Bax]], [[Martin Leon]], [[Philippe Pibarot]] & [[Nicolas Van Mieghem]]
| title = TCT-819 Clinical Outcome in Patients with Heart Failure and Moderate Aortic Stenosis
| journal = [[Journal of the American College of Cardiology]]
| volume = 68
| issue = 18S
| pages = B331–B332
| year = 2016
| month = November
| doi = 10.1016/j.jacc.2016.09.910
| pmid = 27970209
}}</ref><ref name="pmid48941512">{{cite journal| author=Ross J, Braunwald E| title=Aortic stenosis. | journal=Circulation | year= 1968 | volume= 38 | issue= 1 Suppl | pages= 61-7 | pmid=4894151 | doi= | pmc= | url= }}</ref><ref name="pmid204358422" />
 
===Extremeties===
 
*[[Peripheral edema]] may be present in a patient who subsequently develops [[congestive heart failure]].<ref>{{Cite journal
| author = [[Michael Behnes]], [[Siegfried Lang]], [[Ole-A. Breithardt]], [[Jens J. Kaden]], [[Dariusch Haghi]], [[Parviz Ahmad-Nejad]], [[Elif Elmas]], [[Christian Wolpert]], [[Martin Borggrefe]], [[Michael Neumaier]] & [[Martina Brueckmann]]
| title = Association of NT-proBNP with severity of heart valve disease in a medical patient population presenting with acute dyspnea or peripheral edema
| journal = [[The Journal of heart valve disease]]
| volume = 17
| issue = 5
| pages = 557–565
| year = 2008
| month = September
| pmid = 18980090
}}</ref><ref name="pmid204358422" />
| text-align: center;" |
===Symptoms by Age Group===
====Symptoms in Adults<ref name="pmid204241502">{{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="pmid115596732">{{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="pmid110294802">{{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="pmid234895262">{{cite journal| author=Park SJ, Enriquez-Sarano M, Chang SA, Choi JO, Lee SC, Park SW et al.| title=Hemodynamic patterns for symptomatic presentations of severe aortic stenosis. | journal=JACC Cardiovasc Imaging | year= 2013 | volume= 6 | issue= 2 | pages= 137-46 | pmid=23489526 | doi=10.1016/j.jcmg.2012.10.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23489526  }}</ref>====
 
*[[Breathlessness]] with activity
*[[Chest pain]], which resembles what is known as [[angina]]-type pain
**The pain is crushing, squeezing, pressure or tightness in nature
**The pain increases with exercise, relieved with rest.
*[[Fainting]], [[weakness]], or [[dizziness]] with activity
*[[Sensation of feeling the heart beat]] ([[palpitations]])
 
====Symptoms in Infants and Children====
The following symptoms were observed in infants and children with [[aortic stenosis]].<ref name="pmid60207392">{{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="pmid135050142">{{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><ref name="pmid218294082">{{cite journal| author=Yun SW| title=Congenital heart disease in the newborn requiring early intervention. | journal=Korean J Pediatr | year= 2011 | volume= 54 | issue= 5 | pages= 183-91 | pmid=21829408 | doi=10.3345/kjp.2011.54.5.183 | pmc=3145901 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21829408  }}</ref>
 
*Becoming tired or [[fatigue]]d with exertion more easily than others (in mild cases)
*Serious breathing problems that develop within days or weeks of birth (in severe cases)
*Extreme [[fatigue]]
*[[Sweating]]
*Pale skin
*[[Fast breathing]]
*They may also be [[smaller than other children their age]]
*Children with mild or moderate aortic stenosis may get worse as they get older. They also run the risk of developing an infection of the heart valves ([[bacterial endocarditis]]).
|-
|
| colspan="4" |
=== '''heart'''<ref name="pmid22379596">{{cite journal| author=Nassar PN, Hamdan RH| title=Cor Triatriatum Sinistrum: Classification and Imaging Modalities. | journal=Eur J Cardiovasc Med | year= 2011 | volume= 1 | issue= 3 | pages= 84-87 | pmid=22379596 | doi=10.5083/ejcm.20424884.21 | pmc=3286827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22379596  }}</ref><ref name="pmid17170355">{{cite journal| author=Roudaut R, Serri K, Lafitte S| title=Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. | journal=Heart | year= 2007 | volume= 93 | issue= 1 | pages= 137-42 | pmid=17170355 | doi=10.1136/hrt.2005.071183 | pmc=1861363 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17170355  }}</ref><ref name="pmid19604402">{{cite journal| author=Apostolakis EE, Baikoussis NG| title=Methods of estimation of mitral valve regurgitation for the cardiac surgeon. | journal=J Cardiothorac Surg | year= 2009 | volume= 4 | issue=  | pages= 34 | pmid=19604402 | doi=10.1186/1749-8090-4-34 | pmc=2723095 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19604402 }}</ref> ===
 
* [[JVD|Jugular vein distension]]
 
* Apical impulse displaced laterally or not palpable
 
* Diastolic thrill at the apex
 
* Signs of heart failure in severe case
* the murmur will be Diastolic murmur, Low pitched, Opening snap followed by decrescendo-crescendo rumbling murmur.
|
* [[Dyspnea on exertion]]
 
* [[Paroxysmal nocturnal dyspnea]]
 
* [[Orthopnea]]
 
* New onset [[atrial fibrillation]]
|-
|
| colspan="4" | +
|-
|
| colspan="4" | +
|}<br />
{{Heart murmur}}
{{Heart murmur}}


Revision as of 03:01, 28 September 2020


Disease Clinical features
Signs Symptoms
Aortic stenosis

Vitals

Heart

Lungs

Extremeties

Symptoms by Age Group

Symptoms in Adults[16][17][18][19]

Symptoms in Infants and Children

The following symptoms were observed in infants and children with aortic stenosis.[20][21][22]

heart[23][24][25]

  • Apical impulse displaced laterally or not palpable
  • Diastolic thrill at the apex
  • Signs of heart failure in severe case
  • the murmur will be Diastolic murmur, Low pitched, Opening snap followed by decrescendo-crescendo rumbling murmur.
+
+


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References

  1. ↑ Bermejo J (2005). "The effects of hypertension on aortic valve stenosis". Heart. 91 (3): 280–2. doi:10.1136/hrt.2004.041749. PMC 1768786. PMID 15710699.
  2. ↑ J. BERGERON, W. H. ABELMANN, H. VAZQUEZ-MILAN & L. B. ELLIS (1954). "Aortic stenosis; clinical manifestations and course of the disease; review of one hundred proved cases". A.M.A. archives of internal medicine. 94 (6): 911–924. PMID 13217489. Unknown parameter |month= ignored (help)
  3. ↑ Etchells E, Bell C, Robb K (1997). "Does this patient have an abnormal systolic murmur?". JAMA : the Journal of the American Medical Association. 277 (7): 564–71. PMID 9032164. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  4. ↑ FLEMING PR (1957). "The mechanism of the pulsus bisferiens". Br Heart J. 19 (4): 519–24. PMC 503962. PMID 13471818.
  5. ↑ Blase A. Carabello & Walter J. Paulus (2009). "Aortic stenosis". Lancet (London, England). 373 (9667): 956–966. doi:10.1016/S0140-6736(09)60211-7. PMID 19232707. Unknown parameter |month= ignored (help)
  6. ↑ R. H. Swanton, B. S. Jenkins, I. A. Brooksby & M. M. Webb-Peploe (1976). "An analysis of pulsus alternans in aortic stenosis". European journal of cardiology. 4 (1): 39–47. PMID 1261578. Unknown parameter |month= ignored (help)
  7. ↑ S. J. Galloway, W. J. Casarella & P. M. Shimkin (1974). "Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis". Radiology. 113 (1): 11–15. doi:10.1148/113.1.11. PMID 4547644. Unknown parameter |month= ignored (help)
  8. ↑ 8.0 8.1 8.2 8.3 8.4 Maganti K, Rigolin VH, Sarano ME, Bonow RO (2010). "Valvular heart disease: diagnosis and management". Mayo Clin Proc. 85 (5): 483–500. doi:10.4065/mcp.2009.0706. PMC 2861980. PMID 20435842.
  9. ↑ S. J. Galloway, W. J. Casarella & P. M. Shimkin (1974). "Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis". Radiology. 113 (1): 11–15. doi:10.1148/113.1.11. PMID 4547644. Unknown parameter |month= ignored (help)
  10. ↑ Ilias Maglogiannis, Euripidis Loukis, Elias Zafiropoulos & Antonis Stasis (2009). "Support Vectors Machine-based identification of heart valve diseases using heart sounds". Computer methods and programs in biomedicine. 95 (1): 47–61. doi:10.1016/j.cmpb.2009.01.003. PMID 19269056. Unknown parameter |month= ignored (help)
  11. ↑ Chance M. Witt, William R. Miranda & Darrell B. Newman (2016). "The maverick heart sound". Heart (British Cardiac Society). 102 (13): 1008. doi:10.1136/heartjnl-2015-309131. PMID 26919867. Unknown parameter |month= ignored (help)
  12. ↑ Atsuko Furukawa, Yukio Abe, Makoto Ito, Chiharu Tanaka, Kazato Ito, Ryushi Komatsu, Kazuo Haze, Takahiko Naruko, Minoru Yoshiyama & Junichi Yoshikawa (2017). "Prediction of aortic stenosis-related events in patients with systolic ejection murmur using pocket-sized echocardiography". Journal of cardiology. 69 (1): 189–194. doi:10.1016/j.jjcc.2016.02.021. PMID 27012751. Unknown parameter |month= ignored (help)
  13. ↑ Lennart van Gils, Marie-Annick Clavel, Mara Vollema, Victoria Delgado, Tamim Nazif, Ernest Spitzer, Rebecca Hahn, Jeroen Bax, Martin Leon, Philippe Pibarot & Nicolas Van Mieghem (2016). "TCT-819 Clinical Outcome in Patients with Heart Failure and Moderate Aortic Stenosis". Journal of the American College of Cardiology. 68 (18S): B331–B332. doi:10.1016/j.jacc.2016.09.910. PMID 27970209. Unknown parameter |month= ignored (help)
  14. ↑ Ross J, Braunwald E (1968). "Aortic stenosis". Circulation. 38 (1 Suppl): 61–7. PMID 4894151.
  15. ↑ Michael Behnes, Siegfried Lang, Ole-A. Breithardt, Jens J. Kaden, Dariusch Haghi, Parviz Ahmad-Nejad, Elif Elmas, Christian Wolpert, Martin Borggrefe, Michael Neumaier & Martina Brueckmann (2008). "Association of NT-proBNP with severity of heart valve disease in a medical patient population presenting with acute dyspnea or peripheral edema". The Journal of heart valve disease. 17 (5): 557–565. PMID 18980090. Unknown parameter |month= ignored (help)
  16. ↑ 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.
  17. ↑ 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.
  18. ↑ 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.
  19. ↑ Park SJ, Enriquez-Sarano M, Chang SA, Choi JO, Lee SC, Park SW; et al. (2013). "Hemodynamic patterns for symptomatic presentations of severe aortic stenosis". JACC Cardiovasc Imaging. 6 (2): 137–46. doi:10.1016/j.jcmg.2012.10.013. PMID 23489526.
  20. ↑ 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.
  21. ↑ ONGLEY PA, NADAS AS, PAUL MH, RUDOLPH AM, STARKEY GW (1958). "Aortic stenosis in infants and children". Pediatrics. 21 (2): 207–21. PMID 13505014.
  22. ↑ Yun SW (2011). "Congenital heart disease in the newborn requiring early intervention". Korean J Pediatr. 54 (5): 183–91. doi:10.3345/kjp.2011.54.5.183. PMC 3145901. PMID 21829408.
  23. ↑ Nassar PN, Hamdan RH (2011). "Cor Triatriatum Sinistrum: Classification and Imaging Modalities". Eur J Cardiovasc Med. 1 (3): 84–87. doi:10.5083/ejcm.20424884.21. PMC 3286827. PMID 22379596.
  24. ↑ Roudaut R, Serri K, Lafitte S (2007). "Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations". Heart. 93 (1): 137–42. doi:10.1136/hrt.2005.071183. PMC 1861363. PMID 17170355.
  25. ↑ Apostolakis EE, Baikoussis NG (2009). "Methods of estimation of mitral valve regurgitation for the cardiac surgeon". J Cardiothorac Surg. 4: 34. doi:10.1186/1749-8090-4-34. PMC 2723095. PMID 19604402.

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