Aortic stenosis in older adults and causes of aortic regurgitation
THE CONTEXT
This passage describes how aortic stenosis presents and is treated in older adults, followed by congenital and acquired causes of aortic regurgitation.
Aortic stenosis in older adults
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Aortic stenosis is described as the most common form of valve disease in older adults and is a common cause of syncope, angina and heart failure.
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Increasing stiffness of the central arteries may obscure the expected low pulse pressure and slow-rising pulse.
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Transcatheter aortic valve implantation is a good option in older individuals because it is less invasive than surgery.
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Surgery can succeed in patients aged 80 years or more without comorbidity, although operative mortality is higher. Prognosis without surgery is poor once symptoms develop.
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A biological valve is often preferred because it avoids the need for anticoagulation and its durability usually exceeds the patient's anticipated life expectancy.
Causes of aortic regurgitation
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Congenital causes include a bicuspid valve or disproportionate cusps.
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Acquired causes include rheumatic disease, infective endocarditis and trauma.
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Listed causes of aortic dilatation associated with regurgitation are Marfan syndrome, aneurysm, aortic dissection, syphilis and ankylosing spondylitis.