Aortic Stenosis

Bicuspid aortic valve

Overview

• occurs in 1-2% of the population
• usually asymptomatic in childhood
• the majority eventually develop aortic stenosis or regurgitation
• associated with a left dominant coronary circulation (the posterior descending artery arises from the circumflex instead of the right coronary artery) and Turner's syndrome
• around 5% of patients also have coarctation of the aorta

Complications

• aortic stenosis/regurgitation as above
• higher risk for aortic dissection and aneurysm formation of the ascending aorta

Aortic Regurgitation

Hx - HTN, RHD, Endocarditis, and cystic medial necrosis;

rarely, Marfan's syndrome, ankylosing spondylitis, syphilis, and reactive arthritis (Reiter's syndrome)

SOB and fatigue are the most common presentation.

O/E