Wednesday, March 10, 2010

Prognosis and Complication of AS

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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