Aortic stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) (AS), or the narrowing of the aortic valve Aortic valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Heart: Anatomy aperture, is the most common valvular heart disease. While rheumatic heart disease Rheumatic Heart Disease Cardiac manifestation of systemic rheumatological conditions, such as rheumatic fever. Rheumatic heart disease can involve any part the heart, most often the heart valves and the endocardium. Rheumatic Fever remains the most frequent etiology worldwide, degenerative AS and congenital Congenital Chorioretinitis bicuspid valve defect are the 2 usual causes in developed countries. Aortic stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) gradually progresses to heart failure Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (ventricular dysfunction), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as myocardial infarction. Total Anomalous Pulmonary Venous Return (TAPVR), producing exertional dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea, angina, and/or syncope Syncope Syncope is a short-term loss of consciousness and loss of postural stability followed by spontaneous return of consciousness to the previous neurologic baseline without the need for resuscitation. The condition is caused by transient interruption of cerebral blood flow that may be benign or related to a underlying life-threatening condition. Syncope. A crescendo-decrescendo systolic murmur is audible in the right upper sternal border. Doppler Doppler Ultrasonography applying the doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. Ultrasound (Sonography) echocardiography Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Tricuspid Valve Atresia (TVA) is the imaging of choice, showing structural and flow Flow Blood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls. Vascular Resistance, Flow, and Mean Arterial Pressure changes in the valvular area. Valve replacement is the only effective treatment for symptomatic severe AS. Indications for the procedure depend on the patient's symptoms, degree of AS severity, exercise tolerance Tolerance Pharmacokinetics and Pharmacodynamics, concurrent cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) abnormalities, surgical risk, and life expectancy Life expectancy Based on known statistical data, the number of years which any person of a given age may reasonably expected to live. Population Pyramids.
Last updated: 6 Mar, 2022
Aortic stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) (AS) is the narrowing of the aortic valve Aortic valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Heart: Anatomy aperture.
Short- axis Axis The second cervical vertebra. Vertebral Column: Anatomy view of the aortic valve Aortic valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Heart: Anatomy of the heart ( echocardiogram Echocardiogram Transposition of the Great Vessels and image of anatomy).
Image: “ Aortic valve Aortic valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Heart: Anatomy sa” by Patrick J. Lynch and C. Carl Jaffe. License: CC BY 2.5.Bicuspid valve.
Image: “Heart bicuspid aortic valve Aortic valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Heart: Anatomy” by Patrick J. Lynch, medical illustrator. License: CC BY 2.5.Image demonstrates the relationship Relationship A connection, association, or involvement between 2 or more parties. Clinician–Patient Relationship between left ventricular pressure (green line) and aortic pressure Aortic pressure Cardiac Mechanics (red line) throughout the cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) cycle Cycle The type of signal that ends the inspiratory phase delivered by the ventilator Invasive Mechanical Ventilation. The circle corresponds with the point at which the aortic valve Aortic valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Heart: Anatomy would normally open, beginning the ventricular ejection Ventricular ejection Cardiac Cycle phase. In aortic stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS), left ventricular pressure exceeds the aortic pressure Aortic pressure Cardiac Mechanics to overcome the stenotic valve. This leads to a systolic ejection murmur.
Image by Lecturio.Phonocardiograms of abnormal
heart sounds
Heart sounds
Heart sounds are brief, transient sounds produced by valve opening and closure and by movement of blood in the heart. They are divided into systolic and diastolic sounds. In most cases, only the first (S1) and second (S2) heart sounds are heard. These are high-frequency sounds and arise from aortic and pulmonary valve closure (S1), as well as mitral and tricuspid valve closure (S2).
Heart Sounds caused by the following
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) defects:
aortic
regurgitation
Regurgitation
Gastroesophageal Reflux Disease (GERD),
mitral valve prolapse
Mitral valve prolapse
Abnormal protrusion or billowing of one or both of the leaflets of mitral valve into the left atrium during systole. This allows the backflow of blood into left atrium leading to mitral valve insufficiency, systolic murmurs, or cardiac arrhythmia.
Mitral Valve Prolapse, mitral
stenosis
Stenosis
Hypoplastic Left Heart Syndrome (HLHS) (
MS
MS
Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease that leads to demyelination of the nerves in the CNS. Young women are more predominantly affected by this most common demyelinating condition.
Multiple Sclerosis), aortic
stenosis
Stenosis
Hypoplastic Left Heart Syndrome (HLHS) (AS), tricuspid
regurgitation
Regurgitation
Gastroesophageal Reflux Disease (GERD), hypertrophic obstructive
cardiomyopathy
Cardiomyopathy
Cardiomyopathy refers to a group of myocardial diseases associated with structural changes of the heart muscles (myocardium) and impaired systolic and/or diastolic function in the absence of other heart disorders (coronary artery disease, hypertension, valvular disease, and congenital heart disease).
Cardiomyopathy: Overview and Types (HOCM),
atrial septal defect
Atrial Septal Defect
Atrial septal defects (ASDs) are benign acyanotic congenital heart defects characterized by an opening in the interatrial septum that causes blood to flow from the left atrium (LA) to the right atrium (RA) (left-to-right shunt).
Atrial Septal Defect (ASD) (
ASD
ASD
Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by poor social skills, restricted interests/social interactions, and repetitive/stereotyped behaviors. The condition is termed a “spectrum” because of the wide variability in the severity of symptoms exhibited.
Autism Spectrum Disorder),
ventricular septal defect
Ventricular Septal Defect
Tetralogy of Fallot (VSD), and
patent ductus arteriosus
Patent ductus arteriosus
The ductus arteriosus (DA) allows blood to bypass pulmonary circulation. After birth, the DA remains open for up to 72 hours and then constricts and involutes, becoming the ligamentum arteriosum. Failure of this process to occur results in patent ductus arteriosus (PDA), a condition that causes up to 10% of congenital heart defects.
Patent Ductus Arteriosus (PDA) (
PDA
PDA
The ductus arteriosus (DA) allows blood to bypass pulmonary circulation. After birth, the DA remains open for up to 72 hours and then constricts and involutes, becoming the ligamentum arteriosum. Failure of this process to occur results in patent ductus arteriosus (PDA), a condition that causes up to 10% of congenital heart defects.
Patent Ductus Arteriosus (PDA))
Audio:
This audio clip is an example of severe aortic stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS). This is a harsh, crescendo-decrescendo murmur occurring between S1 S1 Heart Sounds and S2 S2 Heart Sounds. Due to the severity of the aortic stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS), the S2 S2 Heart Sounds heart sound is inaudible.
Gross pathology of rheumatic heart disease Rheumatic Heart Disease Cardiac manifestation of systemic rheumatological conditions, such as rheumatic fever. Rheumatic heart disease can involve any part the heart, most often the heart valves and the endocardium. Rheumatic Fever: AS.
Image: “Aortic stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) rheumatic” by CDC/Dr. Edwin P. Ewing, Jr. License: Public domain.Pre-procedure transthoracic echocardiogram Transthoracic echocardiogram Endocarditis. A: parasternal long- axis Axis The second cervical vertebra. Vertebral Column: Anatomy view of severe AS. B: parasternal short- axis Axis The second cervical vertebra. Vertebral Column: Anatomy view of 0.67-cm² aortic valve Aortic valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Heart: Anatomy, consistent with severe stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS).
Image: “Pre-procedure transthoracic echocardiogram Transthoracic echocardiogram Endocarditis” by Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan. License: CC BY 4.0.