Paediatrics: Aortic Stenosis: Free MSRA Podcast

⚕️FREE MSRA PODCAST –Aortic Stenosis🎧 A clear, high-yield breakdown of this critical paediatric heart valvecondition – perfect for exam prep andreal-life clinical scenarios. 🧠Key Learning Points📌Definition• Aortic stenosis(AS) is the narrowing of the aortic valve opening, restricting blood flow fromthe left ventricle to the aorta. In children, it’s usually congenital, but itcan also be acquired.📌Causes & RiskFactors• Congenital bicuspid aortic valve (most commonin children – valve with two leaflets instead of three)• Other congenitalmalformations: unicuspid valve, supravalvular AS (e.g. Williams syndrome)• Age-related calcification (main cause inadults)• Post-inflammatory (e.g. rheumatic fever)• Family history, hypertension, chronic kidneydisease• Mnemonic: WATT – Williams,Aortic coarctation, Turner syndrome, and bicuspid valve• Mnemonic for general risk: Ages & Associations:Age, Anomalies (congenital), Genetics, Elevated arterial pressure(hypertension), Syndromes📌Pathophysiology• Narrowed valveincreases resistance → left ventricle must work harder• Left ventricular hypertrophy develops as themuscle thickens to compensate• If uncorrected,eventually leads to heart failure as the muscle stiffens and function declines📌Symptoms• May be asymptomatic (mild/moderate AS in children)• Classic triad (Mnemonic: SAD): – Syncope (fainting) – Angina (chest pain) – Dyspnoea (shortness of breath)• Others: Fatigue,palpitations, heart failure signs (swollen legs, poor feeding in infants,tachypnoea, hepatomegaly)• Severe in neonates/infants: Cyanosis, weakpulses, heart failure📌DifferentialDiagnosis• Innocent/flowmurmurs (esp. in children)• Aortic sclerosis• Aorticregurgitation• Infectiveendocarditis• Aortic rootdilation• Pulmonary valvestenosis• Septal defects(ASD/VSD)📌Diagnosis• Echocardiography (gold standard: assessesvalve, severity, LV function)• ECG: May show LV hypertrophy• CXR: May show enlarged heart, calcification• Others: BNP, exercise testing, CT/MRI(occasionally), cardiac catheterisation if unclear• Severity (Echo gradients): – Mild: Mean <25 mmHg – Moderate: 25–40 mmHg – Severe: >40 mmHg📌Management• All paediatric cases: Refer to paediatriccardiology• Mild: Regular follow-up, observation• Moderate/severe: Balloon valvuloplasty(children), surgical repair/replacement (esp. with symptoms or severe gradient)• Adults: SAVR (surgical) or TAVI(transcatheter), depending on risk/profile• Treat heart failure or arrhythmias as needed• No medical cure; medications are forsymptom/support only• NICE: Symptomatic severe AS = urgentintervention; consider for asymptomatic severe AS with LV dysfunction orabnormal exercise test📌Complications• Heart failure• Arrhythmias (e.g.AF)• Infective endocarditis• Stroke/embolism• Sudden cardiacdeath (rare in asymptomatic, higher in severe/symptomatic)📌Prognosis• Variable; worsewith symptoms, severe gradient, or LV dysfunction• Without intervention: Poor survival in severesymptomatic cases (5-year survival as low as 15–50%)• With valve replacement: Survival and quality oflife greatly improved 📎More MSRA Resourcesfor Aortic Stenosis📝 Revision Notes: https://www.passthemsra.com/topic/aortic-stenosis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/aortic-stenosis-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/aortic-stenosis-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/aortic-stenosis-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/paediatrics-for-the-msra/ #MSRA #MSRARevision#MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes#MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision#MSRARevisionWebsite #AorticStenosis