Metwally, M. (2017). Clinical Short-Term Outcome of Severe Untreated Aortic Stenosis. The Egyptian Journal of Hospital Medicine, 68(1), 806-814. doi: 10.12816/0038178
Mohsen Fahmy Metwally. "Clinical Short-Term Outcome of Severe Untreated Aortic Stenosis". The Egyptian Journal of Hospital Medicine, 68, 1, 2017, 806-814. doi: 10.12816/0038178
Metwally, M. (2017). 'Clinical Short-Term Outcome of Severe Untreated Aortic Stenosis', The Egyptian Journal of Hospital Medicine, 68(1), pp. 806-814. doi: 10.12816/0038178
Metwally, M. Clinical Short-Term Outcome of Severe Untreated Aortic Stenosis. The Egyptian Journal of Hospital Medicine, 2017; 68(1): 806-814. doi: 10.12816/0038178
Clinical Short-Term Outcome of Severe Untreated Aortic Stenosis
Department of Cardiology, Ain Shams - Faculty of Medicine
Abstract
Background: sclerocalcific aortic valve is a common condition. Risk stratification and decision making are particularly complex in adults with aortic stenosis (AS), because the disease mainly affects elderly patients who represent a heterogeneous population and require balanced and individualized analysis using a multidisciplinary collaboration. Further research is needed to provide better evidence in particular on spontaneous risk, earlier detection of LV dysfunction, and the results of transcatheter treatment and medical therapy. Objectives: to study the clinical short term outcome of the severe untreated severe sclerocalcific aortic valve stenosis and also to evaluate the correlation between echocardiography assessment of aortic stenosis and clinical history and examination. Methods: in our study of 50 patients with severe sclerocalcific aortic stenosis, were subjected to full history taking along with full clinical examination and transthoracic echocardiography at baseline and follow up. The TTE criteria for diagnosis of severe Sclerocalcific aortic stenosis are increased echogenicity and thickening of the aortic valve leaflets with mean gradient greater than 40 mm Hg, and maximum jet velocity greater than 4 m per second, valve area less than 1.0 cm2. Results: at short term follow up of our patients (2 years), there were significant increase in the number of patients who developed symptoms of angina and heart failure (p<0.01) but there was no statistically significant increase in those who develop syncope (P=0.106). There were very evident echocardiographic findings in the form of highly significant (p<0.01) decrease in the EF & valve area and increase in the MPG, PPG, Max. Jet velocity. Conclusion: 41.2% of previously asymptomatic patient developed symptoms at follow up. There were very evident and significant changes in the echocardiographic findings related to significant decrease in the EF & vave area and increase in the MPG, PPG, Max. jet velocity and intracardiac dimensions that is reflected in the clinical symptoms progression throughout the follow up period.
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