Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about pediatric aortic valve stenosis.

And if you want to follow along with written notes on this topic,

you can follow along at zerodefinals.com slash pediatric aortic stenosis

or in the cardiology section of the

Zero Definals Pediatrics book. So let's get straight into it.

Patients with congenital aortic valve stenosis are born with a narrow aortic valve and this restricts

blood flow from the left ventricle into the aorta.

The severity of the stenosis varies between patients and it will determine what symptoms that

patient has. The aortic valve is normally made up of three leaflets, which are called the

aortic sinuses of valsalva. And these allow blood to flow from the left ventricle into the aorta but prevent

blood from flowing back into the left ventricle. Patients with aortic stenosis may have one, two,

three or even four leaflets on their aortic valve. So how does it present? Mild aortic

stenosis can be completely asymptomatic,

and it can be discovered as an incidental murmur during a routine examination. More significant

aortic stenosis can present with symptoms of fatigue, shortness of breath, dizziness, and fainting.

Symptoms are typically worse on exertion or worse when exercising

because the outflow from the left ventricle cannot keep up with the demand.

Severe aiotic stenosis will present with heart failure within months of birth.

What are the signs on examination?

The key examination finding is an ejection systolic

murmur heard loudest at the aortic area, which is the second intercostal space right sternal border.

...