Aortic insufficiency stages: Difference between revisions
(→Stages) |
(→Stages) |
||
Line 18: | Line 18: | ||
! style="background: #4479BA; color: #F8F8FF"|STAGE | ! style="background: #4479BA; color: #F8F8FF"|STAGE | ||
! style="width: 100px;background: #4479BA; color: #F8F8FF"|DEFINITION | ! style="width: 100px;background: #4479BA; color: #F8F8FF"|DEFINITION | ||
! style="width: 150px;background: #4479BA; color: #F8F8FF"|SYMPTOMS | |||
! style="width: 200px;background: #4479BA; color: #F8F8FF"|VALVE ANATOMY | ! style="width: 200px;background: #4479BA; color: #F8F8FF"|VALVE ANATOMY | ||
! style="width: 300px;background: #4479BA; color: #F8F8FF"|VALVE HEMODYNAMICS | ! style="width: 300px;background: #4479BA; color: #F8F8FF"|VALVE HEMODYNAMICS | ||
! style="width: 200px;background: #4479BA; color: #F8F8FF"|HEMODYNAMIC CONSEQUENCES | ! style="width: 200px;background: #4479BA; color: #F8F8FF"|HEMODYNAMIC CONSEQUENCES | ||
|- | |- | ||
Line 27: | Line 27: | ||
| style="background: #4479BA; color: #F8F8FF"|'''A''' | | style="background: #4479BA; color: #F8F8FF"|'''A''' | ||
| At risk of [[AR]] | | At risk of [[AR]] | ||
| • None | |||
| • Bicuspid valve <br> • Valve [[sclerosis]] <br> • History of [[rheumatic fever]] <br> • [[Infective endocarditis]] | | • Bicuspid valve <br> • Valve [[sclerosis]] <br> • History of [[rheumatic fever]] <br> • [[Infective endocarditis]] | ||
| • '''No regurgitation''' | | • '''No regurgitation''' | ||
| • None | | • None | ||
Line 35: | Line 35: | ||
| style="background: #4479BA; color: #F8F8FF"|'''B''' | | style="background: #4479BA; color: #F8F8FF"|'''B''' | ||
| Progressive [[AR]] | | Progressive [[AR]] | ||
| • None | |||
| • Mild-to-moderate calcification <br> • Rheumatic valve changes <br> • Dilatation of aortic sinuses <br> • [[Infective endocarditis]] | | • Mild-to-moderate calcification <br> • Rheumatic valve changes <br> • Dilatation of aortic sinuses <br> • [[Infective endocarditis]] | ||
| • '''Mild regurgitation''': | | • '''Mild regurgitation''': | ||
Line 51: | Line 52: | ||
: • [[Aortography|Angiography]] grade 2+ | : • [[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 | ||
|- | |- | ||
| style="background: #4479BA; color: #F8F8FF"|'''C''' | | style="background: #4479BA; color: #F8F8FF"|'''C''' | ||
| Asymptomatic severe | | Asymptomatic severe | ||
| • None <br> • Exercise testing to confirm symptom status | |||
| • Calcific aortic valve disease <br> • Rheumatic valve changes <br> • Bicuspid valve <br> • Dilated aortic sinuses <br> • [[Infective endocarditis]] with abnormal leaflet closure | | • Calcific aortic valve disease <br> • Rheumatic valve changes <br> • Bicuspid valve <br> • Dilated aortic sinuses <br> • [[Infective endocarditis]] with abnormal leaflet closure | ||
| • '''Severe regurgitation''' | | • '''Severe regurgitation''' | ||
Line 68: | Line 69: | ||
---- | ---- | ||
• '''C2:''' LV systolic dysfunction with decreased LVEF or severe LV dilatation | • '''C2:''' LV systolic dysfunction with decreased LVEF or severe LV dilatation | ||
|- | |- | ||
| style="background: #4479BA; color: #F8F8FF"|'''D''' | | style="background: #4479BA; color: #F8F8FF"|'''D''' | ||
| Symptomatic severe | | Symptomatic severe | ||
| • Exertional [[dyspnea]] <br> • Exertional [[angina]] <br> • [[HF]] symptoms | |||
| • Calcific aortic valve disease <br> • Rheumatic valve changes <br> • Dilated aortic sinuses <br> • [[Infective endocarditis]] with abnormal leaflet closure | | • Calcific aortic valve disease <br> • Rheumatic valve changes <br> • Dilated aortic sinuses <br> • [[Infective endocarditis]] with abnormal leaflet closure | ||
| | • '''Severe regurgitation''' | | | • '''Severe regurgitation''' | ||
Line 83: | Line 84: | ||
: • [[Aortography|Angiography]] grade 3+ to 4+; | : • [[Aortography|Angiography]] grade 3+ to 4+; | ||
| • Normal or decreased systolic function <br> • Moderate to severe LV dilatation | | • Normal or decreased systolic function <br> • Moderate to severe LV dilatation | ||
Revision as of 13:42, 18 April 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Aortic Regurgitation Microchapters |
Diagnosis |
---|
Treatment |
Acute Aortic regurgitation |
Chronic Aortic regurgitation |
Special Scenarios |
Case Studies |
Aortic insufficiency stages On the Web |
American Roentgen Ray Society Images of Aortic insufficiency stages |
Risk calculators and risk factors for Aortic insufficiency stages |
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, hemodynamics and the patients symptoms.
Stages
Shown below is a table summarizing the stages of aortic regurgitation (AR) according to the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease.[1]
Abbreviations: AR: aortic regurgitation; HF: heart failure; IE: infective endocarditis; LV: left ventricular; LVEF: left ventricular ejection fraction; LVESD: left ventricular end-systolic dimension; LVOT: left ventricular outflow tract; Jet/LVOT : jet width and LVOT ratio
STAGE | DEFINITION | SYMPTOMS | VALVE ANATOMY | VALVE HEMODYNAMICS | HEMODYNAMIC CONSEQUENCES |
---|---|---|---|---|---|
A | At risk of AR | • None | • Bicuspid valve • Valve sclerosis • History of rheumatic fever • Infective endocarditis |
• No regurgitation | • None |
B | Progressive AR | • None | • Mild-to-moderate calcification • Rheumatic valve changes • Dilatation of aortic sinuses • Infective endocarditis |
• Mild regurgitation:
|
• Normal LV systolic function • Normal LV volume or mild LV dilation |
C | Asymptomatic severe | • None • Exercise testing to confirm symptom status |
• Calcific aortic valve disease • Rheumatic valve changes • Bicuspid valve • Dilated aortic sinuses • Infective endocarditis with abnormal leaflet closure |
• Severe regurgitation
|
• C1: Normal LVEF and mild to moderate LV dilatation • C2: LV systolic dysfunction with decreased LVEF or severe LV dilatation |
D | Symptomatic severe | • Exertional dyspnea • Exertional angina • HF symptoms |
• Calcific aortic valve disease • Rheumatic valve changes • Dilated aortic sinuses • Infective endocarditis with abnormal leaflet closure |
• Severe regurgitation
|
• Normal or decreased systolic function • Moderate to severe LV dilatation
|
References
- ↑ Nishimura, R. A.; Otto, C. M.; Bonow, R. O.; Carabello, B. A.; Erwin, J. P.; Guyton, R. A.; O'Gara, P. T.; Ruiz, C. E.; Skubas, N. J.; Sorajja, P.; Sundt, T. M.; Thomas, J. D. (2014). "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0000000000000031. ISSN 0009-7322.