TY  - CHAP
M1  - Book, Section
TI  - Aortic Stenosis
A1  - Kiefer, Todd
A1  - Granger, Christopher B.
A1  - Jackson, Kevin P.
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
A2  - McQuaid, Kenneth R.
Y1  - 2023
N1  - 
T2  - Current Medical Diagnosis & Treatment 2023
AB  - ESSENTIALS  OF  DIAGNOSISCongenital  bicuspid  aortic  valve  (usually  asymptomatic  until  middle  or  old  age).“Degenerative”  or  calcific  aortic  stenosis;  similar  risk  factors  as  atherosclerosis  (symptoms  usually  in  the  elderly).Visual  observation  of  immobile  aortic  valve  plus  a  valve  area  of  less  than  1.0  cm2  define  severe  disease;  low-gradient  but  severe  aortic  stenosis  can  thus  be  recognized  when  the  stroke  volume  is  reduced.Delayed  and  diminished  carotid  pulses.Soft,  absent,  or  paradoxically  split  S2.Harsh  systolic  murmur,  sometimes  with  thrill  along  left  sternal  border,  often  radiating  to  the  neck;  may  be  louder  at  apex  in  older  patients.ECG  usually  shows  LVH;  calcified  valve  on  radiography  or  fluoroscopy.Echocardiography/Doppler  is  diagnostic.Surgery  typically  indicated  for  symptoms.  TAVR  is  approved  for  patients  with  calcific  aortic  stenosis.Intervention  appropriate  even  in  asymptomatic  patients  with  super-severe  aortic  stenosis  (mean  gradient  greater  than  55  mm  Hg)  or  when  undergoing  heart  surgery  for  other  reasons  (eg,  coronary  artery  bypass  grafting  [CABG]).BNP  is  a  marker  of  early  LV  myocardial  failure,  and  high  levels  (three  times  normal)  suggest  poor  prognosis  and  can  be  an  indication  for  intervention.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1193147096
ER  -