Aortic insufficiency stages: Difference between revisions
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(Created page with "__NOTOC__ {{CMG}} {{AE}} {{AL}} ==Overview== According to the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease, Aortic insufficiency ha...") |
(/* Stages {{Cite web | last = | first = | title = 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary | url = http://circ.ahajournals.org/content/early/2014/02/27/CIR.0000000000000029.full.pdf+html | ...) |
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| ❑ Mild-to-moderate calcification <br> ❑ Rheumatic valve changes | | ❑ Mild-to-moderate calcification <br> ❑ Rheumatic valve changes | ||
<br> ❑ Dilated aortic sinuses <br> ❑ [[Infective endocarditis]] | <br> ❑ Dilated aortic sinuses <br> ❑ [[Infective endocarditis]] | ||
| ❑ Mild [[AR]]: Jet width <25% of LVOT | | ❑ Mild [[AR]]: | ||
<br> ❑ Moderate [[AR]]: | : ❑ Jet width <25% of LVOT | ||
: ❑ [[Vena contracta]] <0.3 cm | |||
: ❑ RVol <30 mL/beat; RF <30% | |||
: ❑ ERO <0.10 cm² | |||
: ❑ [[Aortography|Angiography]] grade 1+ | |||
<br> ❑ Moderate [[AR]]: | |||
: ❑ Jet width 25%–64% of LVOT | |||
: ❑ [[Vena contracta]] 0.3–0.6 cm | |||
: ❑ RVol 30–59 mL/beat | |||
: ❑ RF 30%–49% | |||
: ❑ ERO 0.10–0.29 cm² | |||
: ❑ [[Aortography|Angiography]] grade 2+ | |||
| ❑ Normal LV [[systolic function]] <br> ❑ Normal LV volume or mild LV dilation | | ❑ Normal LV [[systolic function]] <br> ❑ Normal LV volume or mild LV dilation | ||
| ❑ None | | ❑ None |
Revision as of 16:41, 5 March 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
According to the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease, Aortic insufficiency has 4 stages based on the valve's anatomy and hemodynamics and the patients symptoms.
Stages [1]
STAGE | DEFINITION | VALVE ANATOMY | VALVE HEMODYNAMICS | HEMODYNAMIC CONSEQUENCES | SYMPTOMS |
---|---|---|---|---|---|
A | At risk of AR | ❑ Bicuspid valve ❑ Valve sclerosis ❑ History of rheumatic fever ❑ Infective endocarditis |
❑ None | ❑ None | ❑ None |
B | Progressive AR | ❑ Mild-to-moderate calcification ❑ Rheumatic valve changes
|
❑ Mild AR:
|
❑ Normal LV systolic function ❑ Normal LV volume or mild LV dilation |
❑ None |
C | Asymptomatic severe AS | ❑ Severe leaflet calcification or congenital stenosis with severely reduced opening | ❑ Vmax ≥ 4 m/s or mean ΔP ≥ 40 mmHg ❑ Very severe AS is a Vmax ≥ m/s or mean ΔP ≥ 60 mmHg |
❑ LV diastolic dysfunction ❑ Mild LVH ❑ Normal LVEF |
❑ None ❑ Exercise testing to confirm symptom status |
D | Symptomatic severe high-gradient AS | ❑ Severe leaflet calcification or congenital stenosis with severely reduced opening | ❑ Vmax ≥ 4 m/s or mean ΔP ≥ 40 mmHg ❑ AVA ≤ 1.0 cm² but may be larger with mixed AS and AR |
❑ LV diastolic dysfunction ❑ LVH ❑ May present with pulmonary hypertension |
❑ Exertional dyspnea or decreased exercise tolerance ❑ Exertional angina ❑ Exertional syncope or presyncope
|
AVA: Aortic valve area; LV: Left ventricle
References
- ↑ "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.