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AS etiology
Congenital vs. Degenerative/Rheumatic aortic stenosis
| Symptom/Finding | Congenital or Degenerative? |
|---|---|
| 2 cusps with a football shaped opening seen on PSAX | Congenital AS (bicuspid) |
| A raphe or underdeveloped cusp may be present. | Congenital AS (bicuspid) |
| Cusps will appear thickened and may exhibit doming | Congenital AS (bicuspid) |
| Post stenotic dilatation of the aortic root and ascending aorta | Both |
| Thickening and calcification of the cusps | Degenerative/rheumatic |
| Decreased excursion of the cusps | Degenerative/rheumatic |
| MAC | Degenerative/rheumatic |
| LVH – long-standing AS | Both |
| LAE due to volume and pressure overload | Degenerative/rheumatic |
| Late stage: LV dilatation, decreased systolic function, LV failure | Degenerative/rheumatic |