Aortic Stenosis: Signs and Symptoms – Valvular Heart Disease | Lecturio
Aug 18, 2023
Aortic Stenosis: Signs and Symptoms – Valvular Heart Disease | Lecturio
This video “Aortic Stenosis: Signs and Symptoms” is part of the Lecturio course “Valvular Heart Disease” ► WATCH the complete course on http://lectur.io/aorticstenosisyt http://lectur.io/aorticstenosisyt https://app.adjust.com/z21zrf https://app.adjust.com/b01fak http://lectur.io/aorticstenosisyt http://lectur.io/subscribe http://lectur.io/playlists https://www.facebook.com/lecturio.med …https://www.instagram.com/lecturio_me …
Content
0.65 -> [Music]
3.77 -> the triad that you're looking for chest
6.12 -> pain sure
7.02 -> with that bigger thickness of the left
8.94 -> ventricle wall you're going to have
10.8 -> angina
11.46 -> because maybe perhaps you can't supply
13.799 -> enough employed heart failure late
16.02 -> finding remember early on the left
18.449 -> ventricle is lifting weights and so
20.189 -> therefore could you is it possible that
22.14 -> your ejection fraction could be
23.279 -> preserved early on and Eric stenosis
25.08 -> sure it can so your ejection fraction
28.019 -> would be what exactly your stroke volume
30.179 -> over edv isn't it so therefore when you
34.38 -> have air dexter notices early on your
36.54 -> ejection fraction could actually be
38.16 -> preserved please be careful do not
40.079 -> confuse that with congestive heart
41.55 -> failure as we shall see later on now as
44.629 -> you continue and there isn't proper
48 -> management of your patient Eric stenosis
49.739 -> guess what happens that ejection
51.69 -> fraction is going to get compromised and
53.55 -> you will go into major heart failure and
56.52 -> if you do at that point at the bad
58.62 -> prognostic indicator here we go there's
63.03 -> the s-1 and s2 what did we say about
64.65 -> this a crescendo decrescendo right
67.17 -> because they are take vows was intent to
69 -> open immediately tell me about the left
71.07 -> ventricular pressure increased or
72.36 -> decreased in comparison to Eric pressure
74.36 -> increased love ventricular pressure
76.619 -> remember the area underneath that curve
78.299 -> the discrepancy between those two curves
80.659 -> represents Eric stenosis
85.009 -> what do you hear this right upper area
90.18 -> right so you find that a ripe right
92.729 -> upper second Cup in a cost of space
95.07 -> that's where you find Eric stenosis to
97.409 -> be the loudest it would be radiating
99.21 -> where to the carotid and lastly in terms
102.03 -> of s2 well which second heart sound will
106.29 -> then close first pulmonic followed by a
109.229 -> auric which is called paradoxical
111.509 -> splitting remember that
112.649 -> so with s2 I told you that there are
115.92 -> particular heart sounds that you want to
117.42 -> pay attention to physiologic verses
120.149 -> widened versus fixed in this case where
122.909 -> paradoxical
126.57 -> the physical examination you would
129.13 -> expect the left ventricle to work really
130.66 -> hard because of increased pressure and
132.55 -> so therefore it will be hyper dynamic
134.05 -> and it's enlarged but left ventricular
136.54 -> hypertrophy you want to make sure that
139.12 -> you catch your patient early on with
141.19 -> aortic stenosis because if that ejection
143.41 -> fraction starts dropping what I say
145.6 -> about prognosis dismal you don't want
148.45 -> that to happen so I need you to be
150.22 -> astute please next an important point is
153.01 -> this something called pulses parvis and
155.91 -> taurus what this means is slow and late
159.58 -> carotid pulse due to wide pay attention
162.519 -> here left ventricle wants to eject blood
165.4 -> during one during systole your patient
168.31 -> has bicuspid aortic valve Wow what can
171.01 -> calcification dystrophic resulting in
173.62 -> aerodeck stenosis what happen a cardiac
175.959 -> output decreased so when you have
178.63 -> decreased cardiac output then what
180.1 -> happens to the post and such it's a
182.62 -> delayed so slow and late is what it's
185.95 -> called pulses Parviz and tardis slow and
190.54 -> late carotid pulse due to what delay in
193.299 -> blood flow across that stenotic artic
196.03 -> valve it is that simple for you to
197.35 -> understand are you gonna have
199.209 -> differential pressures here no such
200.709 -> thing differential pressure give me give
203.59 -> me diagnose wouldn't mean differential
205.269 -> pressure dr. rush increased pressure and
207.73 -> upper extremity lower pressure in the
210.07 -> lower extremity
210.91 -> that's a differential pressure that
212.59 -> what's your diagnosis that your
214.59 -> coronation of the order to be careful
217.269 -> you want to try to bring in
218.32 -> differentials here
227.41 -> [Music]
Source: https://www.youtube.com/watch?v=gh865Uv1gDU
