Lesson 4,
Topic 5
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Prognosis
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- Most cases of aortic stenosis of marked severity result in malignant dysrhythmias and sudden death.
- Mild cases of aortic stenosis live a full life (both normal quality and duration).
- Even cases of moderate stenosis can anticipate a life of normal length and quality.
- The severity of the stenosis can be predicted by Doppler echocardiography.
- Mild SAS: has a pressure gradient between the LV and Ao of <50 mmHg
- Moderate SAS: has a pressure gradient between the LV and Ao of 50 to 80 mmHg
- Severe SAS: has a pressure gradient between the LV and Ao of >80 mmHg
- The authors have observed many dogs with pressure gradients of 100 mmHg experience lives of normal length and quality
- The authors therefore use a threshold of >100 mmHg as a threshold gradient in the mature dog identifying dogs with a poor prognosis.
- Work with Doppler echocardiography indicates that aortic stenosis is a progressive and that the rate of progression is greatest in the immature dog and progresses at a very slow rate in the mature dog.
- It has been reported that if dogs survive with aortic stenosis beyond 3 years, they usually do not have aortic stenosis severe enough to produce a marked effect on LV performance.