SYNCOPE IN AORTIC VALVULAR STENOSIS

@article{Richards1984SYNCOPEIA,
  title={SYNCOPE IN AORTIC VALVULAR STENOSIS},
  author={Arthur Mark Richards and Hamid Ikram and Michael Gary Nicholls and E. J. Hamilton and RosemaryD. Richards},
  journal={The Lancet},
  year={1984},
  volume={324},
  pages={1113-1116}
}
Syncope in aortic stenosis during continuous electrocardiographic monitoring--a case report.
TLDR
Rather than arrhythmia, other mechanisms, such as an inhibitory reflex from left ventricular receptors, should be postulated as the cause of syncope in patients with severe aortic stenosis.
Simulation of Exercise-Induced Syncope in a Heart Model with Severe Aortic Valve Stenosis
TLDR
A lumped-parameter computer simulation based on equivalent electronic circuits that reflect the hemodynamic conditions of a heart with severe AVS and a concomitantly decreased contractility as a long-term detrimental consequence of compensatory left ventricular hypertrophy showed consistency with published case reports of exertional syncope in patients with AVS.
Effect of aortic valve replacement on syncope in patients with aortic stenosis.
TLDR
When patients with aortic stenosis experience syncope unrelated to exertion, the symptom is usually unrelated to the valve disease and another cause should be sought.
Ventricular arrhythmias in adult aortic stenosis: prevalence, mechanisms, and clinical relevance.
TLDR
The prevalence, the electrophysiologic mechanisms, and the possible role of ventricular arrhythmias in the development of symptoms and in the outcome of adult subjects with aortic stenosis are analyzed.
Exercise‐induced syncope and holter‐documented asystole in an endurance runner with moderate aortic stenosis
TLDR
The case of an endurance runner with moderate aortic stenosis, who had recurrent syncope, was reported and the patient was given a beta‐adrenergic blocker, and a pacemaker was implanted because of the profound cardio‐inhibi‐tory response.
Valvular aortic stenosis. A clinical and hemodynamic profile of patients.
TLDR
Clinical and hemodynamic findings in 397 patients with valvular aortic stenosis at their first hemodynamic evaluation were retrospectively reviewed, identifying two categories of symptoms: angina and syncope, which develop during a fully compensated stage of aorta stenosis ("prefailure symptoms") and dyspnea or congestive failure, which signifies various degrees of left ventricular malfunction.
Assessment and management of aortic valve disease in patients with left ventricular dysfunction
TLDR
Aortic valve surgery improves myocardial performance by relief of ventricular afterload in both patients with severe stenosis and those with severe regurgitation regardless of the degree of left ventricular dysfunction.
Valvuloarterial Impedance, But Not Aortic Stenosis Severity, Predicts Syncope in Patients With Aortic Stenosis
TLDR
This study suggests that high Zva, but not conventional parameters of AS, identifies AS patients with an increased risk of syncope, and only Zva was an independent predictor ofsyncope in patients with AS.
Pathophysiology of valvular aortic stenosis in the elderly.
  • M. Cheitlin
  • Medicine
    The American journal of geriatric cardiology
  • 2003
TLDR
It is unlikely that any truly asymptomatic patient over age 80, even with severe aortic stenosis, should be sent to surgery, and prolongation of life for any meaningful length of time is not as important as relief of symptoms and improvement in the quality of life.
...
...

References

SHOWING 1-10 OF 14 REFERENCES
Abnormal vascular responses to exercise in patients with aortic stenosis.
TLDR
The observations suggest that reflex vasodilatation resulting from activation of left ventricular baroreceptors may contribute to exertional syncope in patients with aortic stenosis.
Aortic stenosis, sudden death, and the left ventricular baroceptors.
  • A. Johnson
  • Medicine, Biology
    British heart journal
  • 1971
TLDR
It is suggested that in this unique state of affairs the peripheral systemic vasculature is inappropriately affected by reflex activity arising from baroceptors situated within the left ventricular myocardium.
THE INFLUENCE OF INTRACARDIAC BARORECEPTORS ON VENOUS RETURN, SYSTEMIC VASCULAR VOLUME AND PERIPHERAL RESISTANCE.
TLDR
Investigations were undertaken to determine whether or not these hemodynamic parameters are also modified by activation of intracardiac baroreceptors, and to localize these receptors within the heart.
Critical Congenital Aortic Stenosis with Minimal Electrocardiographic Changes
TLDR
Since surgical relief of aortic stenosis is currently available, it becomes of paramount importance to select for operation the patient whose life may be in jeopardy.
Continuous recording of pulmonary artery pressure in unrestricted subjects.
TLDR
Continuous ambulatory pulmonary artery pressures were recorded using a conventional No 5 French Goodale-Lubin filled catheter linked to the Oxford Medilog system of a portable transducer-perfusion unit and miniaturised recorder allowing accurate pressure recording over the full range of heart rates.
Demonstration that the Atria, Ventricles, and Lungs Each Are Responsible for a Tonic Inhibition of the Vasomotor Center in the Dog
TLDR
Afferent vagal nerves from the lungs and the heart tonically inhibit the vasomotor center because they are caused by receptors in the atria and the ventricles.
...
...