Sandbox Rim: Difference between revisions

Revision as of 18:01, 17 July 2014

Abnormal aortic valve
AND
Reduction in systolic opening

Severe aortic stenosis
Vmax ≥4m/s
ΔPmean ≥40 mmHg

Vmax 3-3.9 m/s
ΔPmean 20-39 mmHg

Is the patient symptomatic?

Yes
(Stage D1)

No
(Stage C)

Yes

No
(Stage B)

LVEF <50%
(Stage C2)

Is LVEF <50%?

The patient is undergoing cardiac surgery

The patient is undergoing cardiac surgery
(Stage C1)

Yes

No

Vmax ≥5m/s
ΔPmean ≥60 mmHg
(Very severe stage C1)
AND
Low surgical risk

Dobutamine stress echocardiography:
Aortic valve area ≤1 cm²
AND
Vmax ≥4 ms
(Stage D2)

Dobutamine stress echocardiography:
Aortic valve area ≤1 cm²
AND
LVEF ≥50%
(Stage D3)

Abnormal exercise treadmill test
(Stage C1)

The symptoms are likely the result of the aortic stenosis

ΔVmax >0.3 m/s/y
AND
Low surgical risk
(Stage C1)

@@ Line 13: / Line 13: @@
 {{Family tree |!|!|,|-|-|-|-|-| F01 |(| F02 | | F03 | | |!| | | | F01= The patient is undergoing cardiac surgery <br> (Stage C1)| F02= Yes| F03= No}}
 {{Family tree |!|!|!| | | | | | | | |!| |!| | | |!| | | |!| | | }}
-{{Family tree |!|!|!| | |,|-|-| G01 |(| G02 | | G03 | | |!| | | | G01= Vmax ≥5m/s<br> ΔPmean ≥60 mmHg<br>(Very severe stage C1)<br> AND<br> Low surgical risk | G02= | G03= }}
+{{Family tree |!|!|!| | |,|-|-| G01 |(| G02 | | G03 | | |!| | | | G01= Vmax ≥5m/s<br> ΔPmean ≥60 mmHg<br>(Very severe stage C1)<br> AND<br> Low surgical risk | G02= Dobutamine stress echocardiography: <br> Aortic valve area ≤1 cm<sup>2</sup> <br> AND <br> Vmax ≥4 ms <br> (Stage D2)| G03= Dobutamine stress echocardiography: <br> Aortic valve area ≤1 cm<sup>2</sup> <br> AND <br> LVEF ≥50% <br> (Stage D3)}}
 {{Family tree |!|!|!| | |!| | | | | |!| |!| | | |!| | | |!| | | }}
-{{Family tree |!|!|!| | |!|,|-| H01 |(| |!| | | H02 | | |!| | | | H01= Abnormal exercise treadmill test <br>(Stage C1)| H02= }}
+{{Family tree |!|!|!| | |!|,|-| H01 |(| |!| | | H02 | | |!| | | | H01= Abnormal exercise treadmill test <br>(Stage C1)| H02= The symptoms are likely the result of the aortic stenosis}}
 {{Family tree |!|!|!| | |!|!| | | | |!| |!| | | |!| | | |!| | }}
 {{Family tree |!|!|!| | |!|!| | I01 |'| |!| | | |!| | | |!| | I01= ΔVmax >0.3 m/s/y <br> AND <br> Low surgical risk <br> (Stage C1)}}