Prognosis
ž Asymptomatic patients generally have a good prognosis
ž Symptoms develop within 5 years in most patients with hemodynamically significant aortic stenosis
ž Risk of sudden death 1% per year
ž Factors known to reduce patient’s survival:
¡ reduced left ventricular ejection fraction
¡ enlarged left ventricle
¡ severe valve calcification
ž Once symptoms develop, aortic stenosis becomes a lethal disease with a 3-year mortality rate of 75%
ž Elderly patients with severe aortic stenosis may have a worse prognosis.
¡ The mortality rate was
¢ 50% 1 year
¢ 65% 2 years.
ž Aortic valve replacement is indicated for symptomatic patients with hemodynamically significant aortic valve stenosis, because their expected life span is reduced
ž 10-year survival rate following aortic valve replacement for pure aortic stenosis is 75%
Complications of Aortic Stenosis
ž Pulmonary oedema:
¡ back pressure of blood inside the heart changes the pressure in the blood vessels of the lungs.
¡ causes congestion and breathing difficulties
ž Congestive heart failure:
¡ A.S compromises the functioning of the heart’s left side.
ž Left ventricular hypertrophy:
¡ Enlargement caused by the extra work of pushing blood through the narrowed valve
¡ cardimegaly
ž Endocarditis:
¡ inflammation of the inner layer of the heart, the endocardium
¡ infective or non-infective, depending on whether a microorganism is the source of the inflammation
¡ Most people who develop endocarditis have heart disease of the valves
ž Heart arrhythmia:
¡ Irregular heartbeat.
¡ Some arrhythmias in the ventricles may be associated with cardiac death, such as ‘ventricular fibrillation’ when the ventricles are reduced to quivering rather than beating.
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