Sandbox MC: Difference between revisions

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{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
! align="center" style="background:#4479BA; color: #FFFFFF;" + |History
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Physical examination
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Physical examination
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! align="center" style="background:#4479BA; color: #FFFFFF;" + |CXR
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CXR
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Echocardiography
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Echocardiography
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cardiac catheterization
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| style="background: #DCDCDC; padding: 5px; text-align: left;" valign="top" | '''[[Aortic valve stenosis]]'''
| style="background: #DCDCDC; padding: 5px; text-align: left;" valign="top" | '''[[Aortic valve stenosis]]'''  
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*Exertional chest pain
*Exertional chest pain
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* '''Very severe AS''': Aortic Vmax ≥ 5 m/s or mean ΔP ≥60 mmHg
* '''Very severe AS''': Aortic Vmax ≥ 5 m/s or mean ΔP ≥60 mmHg
*Ejection fraction (EF) may be normal or reduced
*Ejection fraction (EF) may be normal or reduced
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| style="background: #DCDCDC; padding: 5px; text-align: left;" valign="top" | '''[[Aortic valve sclerosis without stenosis]]'''
| style="background: #DCDCDC; padding: 5px; text-align: left;" valign="top" | '''[[Aortic valve sclerosis without stenosis]]'''
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| style="background: #DCDCDC; padding: 5px; text-align: left;" valign="top" | '''[[Supravalvular stenosis]]'''
| style="background: #DCDCDC; padding: 5px; text-align: left;" valign="top" | '''[[Supravalvular stenosis]]'''
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| style="background: #DCDCDC; padding: 5px; text-align: left;" valign="top" | '''[[Hypertrophic obstructive cardiomyopathy]]'''
| style="background: #DCDCDC; padding: 5px; text-align: left;" valign="top" | '''[[Hypertrophic cardiomyopathy]]'''
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Revision as of 20:00, 18 December 2019

Disease Symptoms Physical examination Cardiac murmur ECG CXR Echocardiography
Aortic valve stenosis
  • Exertional chest pain
  • Dyspnea on exertion
  • Decreased exercise tolerance
  • Exertional syncope/pre-syncope
  • Narrow pulse pressure
  • Normal to anacrotic carotid pulse (parvus et tardus)
  • S1 usually normal
  • A systolic ejection click may be audible afer S1
  • Single S2
  • If severe: paradoxical splitting of S2
  • S4 may be audible
  • Mid-to-late peaking systolic ejection murmur
  • Best heard at right intercostal space
  • Radiates equally to the carotid arteries
  • Decseases with Valsalva maneuver
  • Left ventricular hypertrophy
  • Left ventricular strain pattern
  • Left ventricualar hypertrophy
  • If heart failure is present: pulmonary congestion
  • Aortic valve calcification may be visible
  • Mild AS: Aortic Vmax 2.0-2.9 m/s or mean ΔP <20 mmHg
  • Moderate AS: Aortic Vmax 3.0-3.9 m/s or mean ΔP 20-39 mmHg
  • Severe AS: Aortic Vmax ≥ 4 m/s or mean ΔP ≥40 mmHg; AVA typically ≤ 1.0 cm2 (or AVAi ≤ 0.6 cm2/m2)
  • Very severe AS: Aortic Vmax ≥ 5 m/s or mean ΔP ≥60 mmHg
  • Ejection fraction (EF) may be normal or reduced
Aortic valve sclerosis without stenosis
Supvalvular stenosis
Supravalvular stenosis
Hypertrophic cardiomyopathy