How to Treat: Aortic stenosis - assessment answers

1. What are the characteristic symptoms of the early phase of aortic stenosis?
d. None – patients are asymptomatic

2. How are heart sounds typically described in people with AS?
a. A harsh, late-peaking ejection systolic murmur, loudest at the base of the heart

3. Most delays to diagnosis and treatment of AS stem from delays to access to which of the following modalities?
c. Echocardiography

4. In the setting of normal cardiac output, how is AS graded if the peak velocity of blood through the valve exceeds 4m/s, the mean gradient across the valve exceeds 40mmHg, and the valve area falls below 1.0cm²?
c. Severe

5. The only definitive treatment for AS is aortic valve replacement. True or false?
a. True

6. What is the appropriate clinical response for a patient with truly asymptomatic AS?
b. Close clinical observation by the cardiology clinic

7. Treatment with aortic valve replacement is indicated under which TWO of the following scenarios?
b. AS with symptoms of AS or left ventricular dysfunction
e. Asymptomatic severe AS with abnormalities found upon exercise stress testing

8. What is an advantage of mechanical valves over bioprosthetic valves for aortic valve replacement?
c. Long-term durability

9. Which TWO statements regarding transcatheter aortic valve replacement (TAVR) are correct?
a. A transcatheter valve can be placed inside a failed bioprosthetic valve
d. The risk of a TAVR procedure is largely dictated by CT-defined anatomy

10. Following TAVR, how often should patients be followed up with echocardiography?
c. Every one to two years, then more frequently as valve degeneration is observed