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Cardiovascular Diseases
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Please name the type of aortic dissection shown below:
Which patient(s) is considered to have severe aortic stenosis?
An 82-years-old retired solicitor presents to the ED with chest pain radiating to his jaw. He has hypertension treated with ramipril 5 mg bid (ACE inhibitor) but is otherwise normally fit and well. His admission ECG shows sinus rhythm with ventricular rate of 57 bpm, LV hypertension, and widespread ST segment depression. His peak troponin is 110 ng/l (normal <30 ng/l). He is started on treatment for an acute coronary syndrome and listed for an inpatient angiogram. You are asked to perform bedside echocardiogram as a systolic murmur is heard on the post-take ward round. His aortic valve is heavy calcified, maximal trans-aortic jet velocity is 4.3 m/s, peak trans-aortic gradient is 75 mmHg, mean trans-aortic gradient is 46 mmHg (Figure below). What is the next appropriate step in the management of the above-described patient?
An 82-years-old retired solicitor presents to the ED with chest pain radiating to his jaw. He has hypertension treated with ramipril 5 mg bid (ACE inhibitor) but is otherwise normally fit and well. His admission ECG shows sinus rhythm with ventricular rate of 57 bpm, LV hypertension, and widespread ST segment depression. His peak troponin is 110 ng/l (normal <30 ng/l). He is started on treatment for an acute coronary syndrome and listed for an inpatient angiogram. You are asked to perform bedside echocardiogram as a systolic murmur is heard on the post-take ward round. His aortic valve is heavy calcified, maximal trans-aortic jet velocity is 4.3 m/s, peak trans-aortic gradient is 75 mmHg, mean trans-aortic gradient is 46 mmHg (Figure below).
You manage a 28 years old female patient with Marfan syndrome. Her blood pressure is normal (below 130/80 mmHg), she is in sinus rhythm with HR around 65 bpm. On TTE her ascending aorta is dilated up to 46 mm with only mild aortic regurgitation. Patient has desire for pregnancy. What are your suggestions for further management of this young lady?
Clinical features of severe Aortic Stenosis include:
Please identify the most likely reason of this murmur, heard best at the 2nd left intercostal space
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