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If untreated, severe symptomatic aortic stenosis carries a poor prognosis, with a 2-year mortality rate of 50-60% and a 3-year survival rate of less than 30%. [63] Prognosis after aortic valve replacement for people younger than 65 is about five years less than that of the general population; for people older than 65 it is about the same. [57]
Aortic valve stenosis is the most common cause of LVOTO. Aortic valve stenosis means the aortic valve has narrowed and is not opening freely. The aortic valve opens to allow blood to flow from the left ventricle to the aorta. Stenosis here leads to a narrowing of the passage for blood to flow out of the left ventricle, thus a LVOTO.
In individuals with aortic stenosis or with HCM with an outflow tract gradient, there will be a pressure gradient (difference) between the left ventricle and the aorta, with the left ventricular pressure higher than the aortic pressure. This gradient represents the degree of obstruction that has to be overcome in order to eject blood from the ...
This is sensed by stretch receptors in the walls of vessels in the carotid sinus and aortic arch. [9] These receptors then trigger a sympathetic nervous response to compensate and redistribute blood back into the brain. The sympathetic response causes peripheral vasoconstriction and increased heart rate.
Causes include any obstruction of blood flow to and from the heart. There are multiple, including pulmonary embolism, cardiac tamponade, and tension pneumothorax. Other causes include abdominal compartment syndrome, Hiatal hernia, severe aortic valve stenosis, and disorders of the aorta. Constrictive pericarditis is a rare cause.
Pulmonary embolism is thromboembolism of the lungs, hindering oxygenation and return of blood to the heart. Aortic stenosis hinders circulation by obstructing the cardiac output. Hypertrophic sub-aortic stenosis is overly thick ventricular muscle that dynamically occludes the ventricular outflow tract.
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