Aortic sclerosis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Aortic sclerosis commonly affects elderly population. Microscopic changes reveal lipoprotein accumulation, cellular infiltration and extracellular matrix formation that cause progressive thickening of the aortic valve.<ref name="pmid15967862">{{cite journal |author=Freeman RV, Otto CM |title=Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies |journal=[[Circulation]] |volume=111 |issue=24 |pages=3316–26 |year=2005 |month=June |pmid=15967862 |doi=10.1161/CIRCULATIONAHA.104.486738 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15967862 |accessdate=2012-04-10}}</ref> Aortic sclerosis is defined based on [[transthoracic echocardiography|transthoracic echocardiographic]] findings which include irregular leaflet thickening and focal valve thickening with associated increase in echogenicity.<ref name="pmid15967862">{{cite journal |author=Freeman RV, Otto CM |title=Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies |journal=[[Circulation]] |volume=111 |issue=24 |pages=3316–26 |year=2005 |month=June |pmid=15967862 |doi=10.1161/CIRCULATIONAHA.104.486738 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15967862 |accessdate=2012-04-10}}</ref><ref name="pmid10403851">{{cite journal |author=Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS |title=Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly |journal=[[The New England Journal of Medicine]] |volume=341 |issue=3 |pages=142–7 |year=1999 |month=July |pmid=10403851 |doi=10.1056/NEJM199907153410302 |url=http://dx.doi.org/10.1056/NEJM199907153410302 |accessdate=2012-04-10}}</ref><ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid21295189">{{cite journal |author=Gharacholou SM, Karon BL, Shub C, Pellikka PA |title=Aortic valve sclerosis and clinical outcomes: moving toward a definition |journal=[[The American Journal of Medicine]] |volume=124 |issue=2 |pages=103–10 |year=2011 |month=February |pmid=21295189 |doi=10.1016/j.amjmed.2010.10.012 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(10)00913-7 |accessdate=2012-04-10}}</ref> | Aortic sclerosis commonly affects elderly population. Microscopic changes reveal lipoprotein accumulation, cellular infiltration and extracellular matrix formation that cause progressive thickening of the aortic valve.<ref name="pmid15967862">{{cite journal |author=Freeman RV, Otto CM |title=Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies |journal=[[Circulation]] |volume=111 |issue=24 |pages=3316–26 |year=2005 |month=June |pmid=15967862 |doi=10.1161/CIRCULATIONAHA.104.486738 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15967862 |accessdate=2012-04-10}}</ref> | ||
Aortic sclerosis is defined based on [[transthoracic echocardiography|transthoracic echocardiographic]] findings which include irregular leaflet thickening and focal valve thickening with associated increase in echogenicity.<ref name="pmid15967862">{{cite journal |author=Freeman RV, Otto CM |title=Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies |journal=[[Circulation]] |volume=111 |issue=24 |pages=3316–26 |year=2005 |month=June |pmid=15967862 |doi=10.1161/CIRCULATIONAHA.104.486738 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15967862 |accessdate=2012-04-10}}</ref><ref name="pmid10403851">{{cite journal |author=Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS |title=Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly |journal=[[The New England Journal of Medicine]] |volume=341 |issue=3 |pages=142–7 |year=1999 |month=July |pmid=10403851 |doi=10.1056/NEJM199907153410302 |url=http://dx.doi.org/10.1056/NEJM199907153410302 |accessdate=2012-04-10}}</ref><ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid21295189">{{cite journal |author=Gharacholou SM, Karon BL, Shub C, Pellikka PA |title=Aortic valve sclerosis and clinical outcomes: moving toward a definition |journal=[[The American Journal of Medicine]] |volume=124 |issue=2 |pages=103–10 |year=2011 |month=February |pmid=21295189 |doi=10.1016/j.amjmed.2010.10.012 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(10)00913-7 |accessdate=2012-04-10}}</ref> | |||
Aortic sclerosis is generally an asymptomatic condition and usually detected as an incidental finding on [[transthoracic echocardiography]]. Therefore, physical examination is neither sensitive nor specific for diagnosing aortic sclerosis. | |||
==Physical Examination== | ==Physical Examination== | ||
* Normal S2 | |||
* [[Heart murmur#Systolic Heart Murmurs|Systolic murmur]] | * [[Heart murmur#Systolic Heart Murmurs|Systolic murmur]] | ||
:*Short mid-systolic murmur | |||
:*Best heard at right second intercostal space | |||
*Absence of bilateral radiation to the carotid arteries and normal S2 helps to differentiate aortic sclerosis murmur from [[Aortic stenosis physical examination#Heart|aortic stenosis murmur]] | |||
==References== | ==References== | ||
Revision as of 00:03, 11 April 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
Aortic sclerosis commonly affects elderly population. Microscopic changes reveal lipoprotein accumulation, cellular infiltration and extracellular matrix formation that cause progressive thickening of the aortic valve.[1]
Aortic sclerosis is defined based on transthoracic echocardiographic findings which include irregular leaflet thickening and focal valve thickening with associated increase in echogenicity.[1][2][3][4]
Aortic sclerosis is generally an asymptomatic condition and usually detected as an incidental finding on transthoracic echocardiography. Therefore, physical examination is neither sensitive nor specific for diagnosing aortic sclerosis.
Physical Examination
- Normal S2
- Systolic murmur
- Short mid-systolic murmur
- Best heard at right second intercostal space
- Absence of bilateral radiation to the carotid arteries and normal S2 helps to differentiate aortic sclerosis murmur from aortic stenosis murmur
References
- ↑ 1.0 1.1 Freeman RV, Otto CM (2005). "Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies". Circulation. 111 (24): 3316–26. doi:10.1161/CIRCULATIONAHA.104.486738. PMID 15967862. Retrieved 2012-04-10. Unknown parameter
|month=ignored (help) - ↑ Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS (1999). "Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly". The New England Journal of Medicine. 341 (3): 142–7. doi:10.1056/NEJM199907153410302. PMID 10403851. Retrieved 2012-04-10. Unknown parameter
|month=ignored (help) - ↑ Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM (1997). "Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study". Journal of the American College of Cardiology. 29 (3): 630–4. PMID 9060903. Retrieved 2012-04-10. Unknown parameter
|month=ignored (help) - ↑ Gharacholou SM, Karon BL, Shub C, Pellikka PA (2011). "Aortic valve sclerosis and clinical outcomes: moving toward a definition". The American Journal of Medicine. 124 (2): 103–10. doi:10.1016/j.amjmed.2010.10.012. PMID 21295189. Retrieved 2012-04-10. Unknown parameter
|month=ignored (help)