Low flow low gradient aortic stenosis: clinical pathways
Aortic stenosis patients with severe LV dysfunction and low cardiac output present with relatively low transvalvular gradients. It is difficult to distinguish them from aortic sclerosis and LV dysfunction with low cardiac output. The former condition is severe AS with LV dysfunction and latter is pr...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Elsevier
2014-11-01
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| Series: | Indian Heart Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483214007226 |
| _version_ | 1831808260149084160 |
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| author | I. Sathyamurthy K. Jayanthi |
| author_facet | I. Sathyamurthy K. Jayanthi |
| author_sort | I. Sathyamurthy |
| collection | DOAJ |
| description | Aortic stenosis patients with severe LV dysfunction and low cardiac output present with relatively low transvalvular gradients. It is difficult to distinguish them from aortic sclerosis and LV dysfunction with low cardiac output. The former condition is severe AS with LV dysfunction and latter is primarily a contractile dysfunction. Dobutamine stress echocardiogram is key to diagnosis.
AS with LV dysfunction associated with preserved contractile reserve benefit from valve replacement and those without contractile reserve needs critical evaluation on a case to case basis. Patients of AS with LV dysfunction with associated coronary artery disease need coronary angiograms to decide regarding need for valve replacement with bypass surgery. A subset of AS patients have low flow, low mean gradients with preserved ejection fraction in whom one must evaluate global hemodynamic load to assess ventriculo-arterial impedence.
In this review an approach to the clinical pathways for assessment of low flow, low gradient aortic stenosis has been discussed. |
| first_indexed | 2024-12-22T20:20:02Z |
| format | Article |
| id | doaj.art-06aac96c08404d6fbcd6eab0fdb0a60f |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-22T20:20:02Z |
| publishDate | 2014-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-06aac96c08404d6fbcd6eab0fdb0a60f2022-12-21T18:13:52ZengElsevierIndian Heart Journal0019-48322014-11-0166667267710.1016/j.ihj.2014.10.423Low flow low gradient aortic stenosis: clinical pathwaysI. Sathyamurthy0K. Jayanthi1Director and Interventional Cardiologist, Department of Cardiology, Apollo Main Hospitals, 21, Greams Lane, Off Greams Road, Chennai 600026, IndiaConsultant Interventional Cardiologist, SRM Institutes for Medical Sciences, Vadapalani, Chennai, IndiaAortic stenosis patients with severe LV dysfunction and low cardiac output present with relatively low transvalvular gradients. It is difficult to distinguish them from aortic sclerosis and LV dysfunction with low cardiac output. The former condition is severe AS with LV dysfunction and latter is primarily a contractile dysfunction. Dobutamine stress echocardiogram is key to diagnosis. AS with LV dysfunction associated with preserved contractile reserve benefit from valve replacement and those without contractile reserve needs critical evaluation on a case to case basis. Patients of AS with LV dysfunction with associated coronary artery disease need coronary angiograms to decide regarding need for valve replacement with bypass surgery. A subset of AS patients have low flow, low mean gradients with preserved ejection fraction in whom one must evaluate global hemodynamic load to assess ventriculo-arterial impedence. In this review an approach to the clinical pathways for assessment of low flow, low gradient aortic stenosis has been discussed.http://www.sciencedirect.com/science/article/pii/S0019483214007226Low flow low gradient aortic stenosisSevere aortic stenosis with severe LV dysfunctionDobutamine stress echocardiogramLow flow, low gradient aortic stenosis with preserved LV function |
| spellingShingle | I. Sathyamurthy K. Jayanthi Low flow low gradient aortic stenosis: clinical pathways Indian Heart Journal Low flow low gradient aortic stenosis Severe aortic stenosis with severe LV dysfunction Dobutamine stress echocardiogram Low flow, low gradient aortic stenosis with preserved LV function |
| title | Low flow low gradient aortic stenosis: clinical pathways |
| title_full | Low flow low gradient aortic stenosis: clinical pathways |
| title_fullStr | Low flow low gradient aortic stenosis: clinical pathways |
| title_full_unstemmed | Low flow low gradient aortic stenosis: clinical pathways |
| title_short | Low flow low gradient aortic stenosis: clinical pathways |
| title_sort | low flow low gradient aortic stenosis clinical pathways |
| topic | Low flow low gradient aortic stenosis Severe aortic stenosis with severe LV dysfunction Dobutamine stress echocardiogram Low flow, low gradient aortic stenosis with preserved LV function |
| url | http://www.sciencedirect.com/science/article/pii/S0019483214007226 |
| work_keys_str_mv | AT isathyamurthy lowflowlowgradientaorticstenosisclinicalpathways AT kjayanthi lowflowlowgradientaorticstenosisclinicalpathways |