Aortic stenosis (AS) is a narrowing of the aortic valve area from leaflet fibrosis or calcification, leading to obstruction of the left ventricular (LV) outflow tract.
AS has a long a...
Primary symptoms: angina, syncope, and heart failure. Angina is the most frequent symptom. Syncope is often exertional. Heart failure symptoms include fatigue, exertional dyspnea, ort...
No effective medical therapy for severe or symptomatic AS
Currently, more research into the pro-inflammatory cytokines, clotting factors, and proteins involved in promoting calcific...
I35.0 Nonrheumatic aortic (valve) stenosis
I06.0 Rheumatic aortic stenosis
Q23.0 Congenital stenosis of aortic valve
60573004 Aortic valve stenosis (disorder)
72011007 Rheumatic aortic st...
AS is diagnosed on physical exam by a systolic crescendo–decrescendo murmur and delayed/diminished pulses.
Symptomatic AS most commonly presents as angina, syncope, and heart failure.
Sy...
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Calcific aortic stenosis. Large deposits of calcium salts are evident in the cusps and the free margins of the thickened aortic valve, as viewed from above.
Calcific aortic stenosis. Large deposits of calcium salts are evident in the cusps and the free margins of the thickened aortic valve, as ...
Calcific aortic stenosis of a congenitally bicuspid aortic semilunar valve.
<bold>Figure 33-37</bold> Diagram of the cardiac anatomy and physiology in a 1-month-old infant with valvar aortic stenosis had a systolic pressure gradient of 70 mmHg across the aortic valve. The blood passing from left to right through the ductus must return again through the aortic valve, with the excess flow compounding the obstruction. The large atrial shunt, whether a true anomaly or a sprung foramen ovale, elevates left atrial pressure. The numbers below the chamber name are pressure measu...
<bold>Figure 33-37</bold> Diagram of the cardiac anatomy and physiology in a 1-month-old infant with valvar aortic stenosis ha...
<bold>Fig CA 8-2</bold> (A) <bold>Subvalvular aortic stenosis.</bold> Note the muscular ridge protruding from the upper portion of the ventricular septum (arrows). The ridge is approximately 2 cm below the aortic valve and encroaches on the outflow tract of the left ventricle. (B) <bold>Valvular aortic stenosis.</bold> Irregular thickening of aortic valve leaflets and relative rigidity of the left coronary cusp. (C) <bold>Supravalvular aortic stenosis.</bold> Narrowed segment (arrows) located just above the corona...
<bold>Fig CA 8-2</bold> (A) <bold>Subvalvular aortic stenosis.</bold> Note the muscular ridge protruding from the ...
<bold><i>FIGURE 8.19.</i></bold> Two patients with aortic stenosis are included. In both cases, different values for aortic stenosis jet velocity are obtained, yielding different measures of peak gradient. In patient A, the apical view underestimates the true velocity, which is optimally recorded from the right parasternal window. In patient B, the apical window again underestimates true velocity. In this case, the peak gradient was best recorded from the suprasternal notch.
<bold><i>FIGURE 8.19.</i></bold> Two patients with aortic stenosis are included. In both cases, different values f...
<bold><italic>FIGURE 8.21.</bold></bold> This schematic demonstrates the relationship between aortic (<italic>Ao</bold>) and left ventricular (<italic>LV</bold>) pressure in the setting of aortic stenosis. The differences between peak instantaneous, peak-to-peak, and mean gradients are demonstrated.
<bold><italic>FIGURE 8.21.</bold></bold> This schematic demonstrates the relationship between aortic (<italic...
<bold><italic>FIGURE 10.6.</bold></bold> A two-dimensional echocardiogram from a patient with severe aortic stenosis is shown. <bold>A:</bold> The long-axis view reveals an echogenic and very immobile aortic valve. <bold>B:</bold> The corresponding short-axis view suggests a high degree of calcification of the valve and minimal mobility during systole. LA, left atrium; LV, left ventricle; RV, right ventricle.
<bold><italic>FIGURE 10.6.</bold></bold> A two-dimensional echocardiogram from a patient with severe aortic steno...
<bold><i>FIGURE 20.11.</i></bold> Transthoracic parasternal long-axis view of the ascending aorta recorded in a patient with significant valvular aortic stenosis and proximal aortic dilation. Note the dilation of the aorta at the level of the sinuses, sinotubular junction, and proximal ascending aorta. This represents poststenotic dilation. In many instances, dilation to the degree seen here may be due to both disease of the aortic valve and concurrent aortic aneurysm. Ao,...
<bold><i>FIGURE 20.11.</i></bold> Transthoracic parasternal long-axis view of the ascending aorta recorded in a pa...
A 60-year-old man with degenerative calcific aortic stenosis. A: Posteroanterior examination shows increased rounding of the left ventricular portion of the left heart border and dilatation of the ascending aorta (arrows). B: Lateral examination shows aortic valvular calcification (arrowheads) in the center of the cardiac silhouette and filling of the retrosternal air space by the dilated, calcified (arrows) ascending aorta. The left ventricle is not dilated.
A 60-year-old man with degenerative calcific aortic stenosis. A: Posteroanterior examination shows increased rounding of the left ventricu...
Aortic valve dilation in a newborn with critical aortic stenosis. An antegrade catheter is positioned in the left ventricle via the patent foramen ovale.
Aortic valve dilation in a newborn with critical aortic stenosis. An antegrade catheter is positioned in the left ventricle via the patent...
<bold><italic>Figure 13-16</bold> Calcific aortic stenosis.</bold> Congenital bicuspid aortic valve. Valve leaflets are thick and crusted with calcium and frozen in position. This valve is both stenotic and insufficient.
<bold><italic>Figure 13-16</bold> Calcific aortic stenosis.</bold> Congenital bicuspid aortic valve. Valve leaflet...
<bold>FIGURE 11-37. Calcific aortic stenosis of a congenitally bicuspid aortic valve.</bold> The two leaflets are heavily calcified, but there is no commissural fusion.
<bold>FIGURE 11-37. Calcific aortic stenosis of a congenitally bicuspid aortic valve.</bold> The two leaflets are heavily calc...
Auscultation, subvalvular membranous stenosis - Supravalvular aortic stenosis causes the jet to strike the aorta, producing an ejection murmur indistinguishable from that associated with valvular aortic stenosis except that there is no ejection click
Auscultation, subvalvular membranous stenosis - Supravalvular aortic stenosis causes the jet to strike the aorta, producing an ejection mu...
Defect, aortic - Heart demonstrating normal anatomic position of aorta (Ao) in an example of supravalvular aortic stenosis with bilateral superior caval veins. Pulmonary trunk (PT), r. sup. vena cava (RSCV), l. sup. vena cava (LSCV)
Defect, aortic - Heart demonstrating normal anatomic position of aorta (Ao) in an example of supravalvular aortic stenosis with bilateral ...
Cardiac valve, aortic - The aortic valve shown in a simulated open position
Cardiac valve, aortic - The aortic valve shown in a simulated closed position