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Aortic stenosis
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Aortic stenosis

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Contributors: Shea A. Nagle MPH, Mary Anne Morgan MD, Michael W. Winter MD, David Peritz MD, Ryan Hoefen MD, PhD
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Synopsis

Aortic stenosis : Chest pain, Dizziness, Exertional dyspnea, Syncope, Systolic murmur, Orthopnea
Aortic stenosis (AS) is the narrowing of left ventricular outflow through the aortic valve. It is the most prevalent cause of ventricular outflow obstruction, and it is increasing in prevalence as the population ages and life expectancy increases. While patients are generally asymptomatic in the presence of mild outflow obstruction, exertional dyspnea, chest discomfort, fatigue, dizziness, and syncope develop as the degree of obstruction progresses.

Contributing etiologies include calcification of the aortic valve cusps (most common in the elderly population), congenital abnormalities (ie, bicuspid aortic valve), rheumatic fever, chest radiotherapy, endocarditis, and alkaptonuria. Potential complications include heart failure, cardiac arrhythmias, infectious endocarditis, pulmonary hypertension, excessive bleeding, stroke, and other embolic events.

There is no known medical therapy available to delay progression of AS. Patients should be monitored carefully with serial clinical evaluations and echocardiography in order to determine if and when aortic valve replacement is needed, which may be performed by surgical or transcatheter aortic valve replacement (TAVR). Prolonged or intense physical activity and competitive sports should be avoided in patients with severe AS.

Codes

ICD10CM:
I06.0 – Rheumatic aortic stenosis
I35.0 – Nonrheumatic aortic (valve) stenosis

SNOMEDCT:
60573004 – Aortic valve stenosis

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Differential Diagnosis & Pitfalls

Best Tests

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Therapy

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References

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Last Reviewed:01/28/2021
Last Updated:06/08/2022
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Aortic stenosis
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A medical illustration showing key findings of Aortic stenosis : Chest pain, Dizziness, Exertional dyspnea, Syncope, Systolic murmur, Orthopnea
Imaging Studies image of Aortic stenosis - imageId=8368063. Click to open in gallery. caption: '<span>Cardiac MRI without contrast demonstrates aortic stenosis.</span>'
Cardiac MRI without contrast demonstrates aortic stenosis.

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