Acquired valvulopathy: aortic valve diseases
1. Big picture
Aortic valve disease mainly means:
- Aortic stenosis (AS) = the aortic valve does not open properly → pressure overload of the left ventricle.
- Aortic regurgitation / aortic insufficiency (AR/AI) = the aortic valve does not close properly → diastolic backflow from the aorta into the left ventricle → volume overload.
The examiner wants you to recognize the opposite bedside pictures:
| Disease | Core mechanism | Classic pulse | Classic murmur | Main LV response |
|---|---|---|---|---|
| Aortic stenosis | Outflow obstruction | Pulsus parvus et tardus | Harsh systolic ejection murmur radiating to carotids | Concentric LV hypertrophy |
| Aortic regurgitation | Diastolic backflow | Pulsus celer et altus / Corrigan pulse | Early diastolic decrescendo murmur | LV dilatation + eccentric hypertrophy |
Key investigation: transthoracic echocardiography (TTE) with Doppler. Definitive treatment for severe symptomatic disease: aortic valve intervention: surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI), chosen by anatomy, age, surgical risk, comorbidity, and Heart Team assessment. The 2025 ESC/EACTS valvular guideline emphasizes updated diagnosis and treatment pathways for valvular heart disease, including AS and AR. ([European Society of Cardiology][1])
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