Aortic Stenosis

Excerpt

Aortic stenosis is a common valvular disorder leading to left ventricular outflow obstruction. The anterograde velocity across the valve must be at least 2 m/sec, whereas aortic valve sclerosis is the thickening and calcification without a significant pressure gradient. Etiologies include congenital (bicuspid/unicuspid), calcific, and rheumatic disease. Symptoms such as exertional dyspnea or fatigue gradually develop after a long asymptomatic latent period of about 10 to 20 years. Patients go on to develop chest pain, heart failure, and syncope. The definitive treatment for aortic stenosis includes aortic valve replacement, either via a surgical or percutaneous approach. Survival is excellent during the asymptomatic phase, but mortality is more than 90% within a few years after the onset of symptoms.