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Aortic Valvular Stenosis

Jeremy Golding, MD, FAAFP Reviewed 06/2019
 


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. Angina is the most frequent symptom. Syncope is often exertional. Heart failure symptoms include fatigue, exertional dyspnea, ort...

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

  • Serial ECHO: yearly for severe AS, every 1 to 2 y...

REFERENCES

1
Baumgartner H, Falk V, Bax JJ, et al; for ESC Scientific Document Group. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J.  2017;38(36):2739–2791. [...

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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