Appearance mobility gradient



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tarix09.02.2017
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#8209
Aortic Stenosis

14/11/10


OH

Examinations Book

- obstruction can be supravalvular, valvular (most common) or subvalvular.

Severity Assessment
- appearance

- mobility

- gradient (continuous wave Doppler allows peak velocity to be measured -> peak gradient can be calculated using Bernoulli equation (peak gradient = 4 x peak velocity across the narrowing2) – normal peak gradient < 10mmHg, critical > 70mmHg, gradient measurements are very dependent on ventricular function so can be misleading.

- area – normal 2.5-5.5cm2, critical < 0.92cm2



- dimensionless severity index = ratio of LVOT velocity/aortic valve velocity (V1/V2) – provides a dimensionless measurement of aortic stenosis which is independent of Q, < 0.25 implies a valve area of 0.75cm2 (severe AS)

- complications: LV hypertrophy, dilation, systolic and diastolic dysfunction, post-stenotic dilation




Jeremy Fernando (2010)

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