Aortic Stenosis

Overview

Aortic stenosis is narrowing of the aortic valve or left ventricular outflow tract, creating an obstruction to ventricular ejection.

Clinical Features

Classic symptoms include exertional dyspnea, angina, and syncope.

Examination may reveal a harsh ejection systolic murmur radiating toward the carotids and a slow-rising, low-volume carotid pulse in severe disease.

The classic symptomatic triad is angina, syncope, and exertional dyspnea.

Investigation

Echocardiography assesses valve anatomy, transvalvular gradients, valve area, ventricular function, and severity.

Management

Symptomatic severe disease generally requires valve replacement or intervention when appropriate.

Medical treatment alone does not remove the fixed valvular obstruction.

Clinical Pearls