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Aortic Valvular Stenosis

Reviewed 06/2018
 


BASICS

DESCRIPTION

Aortic stenosis (AS) is a narrowing of the aortic valve area causing obstruction to left ventricular (LV) outflow. The disease has a long asymptomatic latency period, but development...

DIAGNOSIS

HISTORY

  • Primary symptoms: angina, syncope, and heart failure (3). Angina is the most frequent symptom. Syncope is often exertional. Heart failure symptoms include fatigue, exertional dyspnea,...

TREATMENT

MEDICATION

  • No effective medical therapy for severe or symptomatic AS

  • Prevention: currently no recommended medical therapy. Statins have been thought to slow progression if initiated during mil...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Advise patients to immediately report symptoms referable to AS.

  • Asymptomatic patients: yearly history and physical (5)[C]

  • Serial ECHO: yearly for severe AS, every 1...

REFERENCES

1
1 Carabello BA, Paulus WJ. Aortic stenosis. Lancet.  2009;373(9667):956–966. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 Otto CM. Calcific aortic stenosis—time to look more cl...

CODES

ICD10

  • I35.0 Nonrheumatic aortic (valve) stenosis

  • I06.0 Rheumatic aortic stenosis

  • Q23.0 Congenital stenosis of aortic valve

ICD9

  • 424.1 Aortic valve disorders

  • 395.0 Rheumatic aortic stenosis

  • 746.3 Congen...

CLINICAL PEARLS

  • AS is diagnosed on physical exam by a systolic crescendo–decrescendo murmur and delayed and diminished pulses.

  • Symptomatic AS most commonly presents as angina, syncope, and heart failur...

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