Aortic stenosis is a narrowing of the aorta caused by several factors such as rheumatic fever, atherosclerosis, or congenital malformations. It results in increased pressure and workload on the left ventricle, causing the ventricle to thicken and enlarge over time. If untreated, aortic stenosis can reduce blood flow to the heart and lead to angina, fainting, heart failure or sudden cardiac death. Diagnosis involves echocardiography, ECG and chest x-ray to detect the thickened aortic valve, enlarged heart chambers and diminished blood flow. Treatment options include medications to manage symptoms as well as surgical procedures to dilate or replace the stenotic aortic valve.

1. AORTIC STENOSISAORTIC STENOSIS

2. DefinitioneDefinitione
• AORTIC STENOSIS is theAORTIC STENOSIS is the
anatomical defect of aorta, in wich aortaanatomical defect of aorta, in wich aorta
is narrowed.Normal diameter aorta is 2.2-is narrowed.Normal diameter aorta is 2.2-
3.7sm in ascendens part and 1.5-2.6sm in3.7sm in ascendens part and 1.5-2.6sm in
valvular regio.valvular regio.

3. ETHIOLOGYETHIOLOGY
• Rheumatic feverRheumatic fever
• AtherosclerosisAtherosclerosis
• Myocardiopathy hyperthrophicalMyocardiopathy hyperthrophical
(subvalvular stenosis)(subvalvular stenosis)
• Congenital malformationsCongenital malformations

4. PATHOPHYSIOLOGYPATHOPHYSIOLOGY
(hemodinamical desorders)(hemodinamical desorders)
• Blood flow is injected from narrowing aorticalBlood flow is injected from narrowing aortical
part due to systole and systolicus murmur ispart due to systole and systolicus murmur is
formaded.Exertione for the left ventricule isformaded.Exertione for the left ventricule is
encreased. This is cause of hypertrophy andencreased. This is cause of hypertrophy and
dilatatione left ventricule,encrease cardiacdilatatione left ventricule,encrease cardiac
output and systolicus arterial pressure.output and systolicus arterial pressure.
• Aortic stenosis is cause of decrease blood flowAortic stenosis is cause of decrease blood flow
in coronary arterias and myocardialin coronary arterias and myocardial
eshemia,arrhytmias ,sudden death may occur.eshemia,arrhytmias ,sudden death may occur.

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6. Clinical symptoms and signsClinical symptoms and signs
ComplanesComplanes
dyspnea and palpitatione for exertionedyspnea and palpitatione for exertione
cardialgia (angina often)cardialgia (angina often)
headache,vertigo(dizziness)headache,vertigo(dizziness)
syncopesyncope

7. ExaminationeExaminatione
• Pallor and acrocyanosisPallor and acrocyanosis
• Systolic thrill in the second right interspace andSystolic thrill in the second right interspace and
along the carotidsalong the carotids
• Apex beat sustainad and heaving in characterApex beat sustainad and heaving in character
dyslocated outwards and downwardsdyslocated outwards and downwards
• Heart borders dyslocated to the leftHeart borders dyslocated to the left
• Systolicus murmur best heard in the aortic areaSystolicus murmur best heard in the aortic area
and at the apex and condacted to the corotisand at the apex and condacted to the corotis
• The first sound is normal,than soft(relief); theThe first sound is normal,than soft(relief); the
second sound is softsecond sound is soft

8. Diagnostics methods:Diagnostics methods:
• Echocardiography(ultrasonography)Echocardiography(ultrasonography)
derect signs: theckened,calcified andderect signs: theckened,calcified and
immobile aortic valve cusps and narrowingimmobile aortic valve cusps and narrowing
aorta. Accelerated transaortal systolicusaorta. Accelerated transaortal systolicus
blood flowblood flow
nonderect signs: left ventrecularnonderect signs: left ventrecular
hypertrophy,dilatationehypertrophy,dilatatione

9. UltrasonographyUltrasonography

10. Diagnostic methodsDiagnostic methods

11. Diagnostics methodsDiagnostics methods
• ECGECG
left ventrecular hypertrophy (S3,R1),left ventrecular hypertrophy (S3,R1),
left axis deviationleft axis deviation
left bundle branch blocksleft bundle branch blocks
• X-ray chestX-ray chest
prominent ascending aorta with postprominent ascending aorta with post
stenotic dilationstenotic dilation
left ventricular enlargementleft ventricular enlargement

12. TREATMENTTREATMENT
• Medicamental treatment:Medicamental treatment:
diet 10, b-blockers,vasodilatators,diet 10, b-blockers,vasodilatators,
nitrites and other symptomatical drugsnitrites and other symptomatical drugs
*Surgical treatment:*Surgical treatment:
balloon dilatationeballoon dilatatione
aortic valve replacement withaortic valve replacement with
prosthetic or tissue valveprosthetic or tissue valve