Aortic Stenosis Questions & Answers

Updated: May 07, 2019
  • Author: Xiushui (Mike) Ren, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Questions & Answers

Overview

What is the role of percutaneous balloon valvuloplasty in the treatment of aortic stenosis (AS)?

What is aortic stenosis (AS)?

What is the classic symptom triad of aortic stenosis (AS)?

What is significant about systolic blood pressure in patients with aortic stenosis (AS)?

How is severe aortic stenosis (AS) characterized?

What are the signs and symptoms of aortic stenosis (AS)?

Which studies are used in the diagnosis and assessment of aortic stenosis (AS)?

What is the definitive treatment for aortic stenosis (AS) in adults?

What is included in emergency treatment of aortic stenosis (AS)?

Which medications are used in the treatment of aortic stenosis (AS)?

What are the ACC/ AHA guidelines for patient selection for aortic valve replacement in aortic stenosis?

What is aortic stenosis (AS)?

What are the initial symptoms of aortic stenosis (AS)?

What is the imaging modality of choice to diagnose aortic stenosis (AS)?

What is the pathophysiology of aortic stenosis (AS)?

How does diastolic dysfunction occur in aortic stenosis (AS)?

What is the pathophysiology of severe aortic stenosis (AS)?

What causes angina in aortic stenosis (AS)?

What is the role of LDL-C in the pathogenesis of aortic stenosis (AS)?

What are the causes of aortic stenosis (AS)?

How is valvular aortic stenosis (AS) categorized?

What is congenital valvular aortic stenosis (AS)?

What is the pathogenesis of congenital valvular aortic stenosis (AS)?

What is the progression of congenital valvular aortic stenosis (AS)?

What are the causes of acquired aortic stenosis (AS)?

What is degenerative calcific aortic stenosis (AS)?

What are the risk factors for degenerative calcific aortic stenosis (AS)?

What is rheumatic aortic stenosis (AS)?

What are infrequent causes of aortic stenosis (AS)?

How are aortic valve leaflets determined in aortic stenosis (AS)?

At what age do symptoms of severe aortic stenosis (AS) usually develop?

What are the prevalence of aortic stenosis (AS) among different age groups?

How does the prevalence of degenerative calcific aortic stenosis (AS) vary by age?

What is the role of left ventricle (LV) outflow tract obstruction (LVOTO) in the etiology of aortic stenosis (AS)?

What is the prognosis of asymptomatic aortic stenosis (AS)?

What is the prognosis of severe aortic stenosis (AS)?

What is the prognosis of symptomatic medically treated, moderate-to-severe aortic stenosis (AS)?

What is the prognosis of degenerative calcific aortic stenosis (AS)?

When can patient education information be found for aortic stenosis (AS)?

Presentation

What are the clinical characteristics of aortic stenosis (AS)?

What is the history of chest pain in patients with aortic stenosis (AS)?

What is the history of heart failure in patients with aortic stenosis (AS)?

What is the history of syncope in patients with aortic stenosis (AS)?

What are the GI manifestations of aortic stenosis (AS)?

What are the signs and symptoms of infective endocarditis in aortic stenosis (AS)?

What is the prevalence of aortic root dilation in aortic stenosis (AS)?

What are complications of calcific aortic stenosis (AS)?

Which physical findings suggest severe aortic stenosis (AS)?

What is the significance of systolic blood pressure in patients with aortic stenosis (AS)?

What is the significance of a finding of pulsus alternans with aortic stenosis (AS)?

What is the significance of a finding of hyperdynamic left ventricle (LV) with aortic stenosis (AS)?

What heart sounds are characteristic of aortic stenosis (AS)?

In which patient group is an ejection click suggestive of aortic stenosis (AS)?

What is the significance of a prominent S4 in aortic stenosis (AS)?

What are characteristics of the classic crescendo-decrescendo systolic murmur in aortic stenosis (AS)?

What are characteristics of the heart murmur in elderly patients with calcific aortic stenosis (AS)?

What is the relationship between the systolic murmur and severity of aortic stenosis (AS)?

What is characteristic of the murmur of valvular aortic stenosis (AS)?

What are less common physical findings of aortic stenosis (AS)?

DDX

Why is a diagnosis of aortic stenosis (AS) often missed in an acute setting?

What is the prevalence of angina pectoris in aortic stenosis (AS)?

Which conditions should be included in the differential diagnoses of aortic stenosis (AS)?

What are the differential diagnoses for Aortic Stenosis?

Workup

Which diagnostic studies for aortic stenosis (AS) should be performed in emergency department (ED)?

What is the imaging modality of choice to diagnose aortic stenosis (AS)?

What is the role of two-dimensional transthoracic echocardiography in the diagnosis of aortic stenosis (AS)?

What are the echocardiographic findings indicative of severe aortic stenosis (AS)?

What is the role of Doppler echocardiography in the diagnosis of aortic stenosis (AS)?

How is a maximum instantaneous and mean aortic valve gradient derived in the diagnosis of aortic stenosis (AS)?

What are the criteria for determining the severity of aortic stenosis (AS)?

What is the role of color Doppler valve analysis in the diagnosis of aortic stenosis (AS)?

What is the limitation of Doppler echocardiography for the diagnosis of aortic stenosis (AS)?

What guidelines exist for the use of echocardiography in patients undergoing transcatheter aortic valve replacement?

What is the role of cardiac catheterization in the diagnosis of aortic stenosis (AS)?

What is the role of contrast ventriculography in the diagnosis of aortic stenosis (AS)?

What is the role of coronary angiography for the diagnosis of aortic stenosis (AS)?

What is the role of radionuclide ventriculography used in the diagnosis of aortic stenosis (AS)?

What are the contraindications for exercise stress testing in the evaluation of aortic stenosis (AS)?

What is the role of exercise stress testing in the diagnosis of aortic stenosis (AS)?

When is provocative stress testing indicated in the diagnosis of aortic stenosis (AS)?

How is the measure of aortic valve area (AVA) used in diagnosis of aortic stenosis (AS)?

What are investigational imaging modalities used for the diagnosis of aortic stenosis (AS)?

What is the role of chest radiography in the diagnosis of aortic stenosis (AS)?

What is the role of ECG in the diagnosis of aortic stenosis (AS)?

What is the prevalence of left ventricular hypertrophy (LVH) on ECG in aortic stenosis (AS)?

Which ECG findings indicate aortic stenosis (AS)?

What is the correlation between absolute voltages in precordial leads and the severity of aortic stenosis (AS)?

What heart rhythms are characteristic of aortic stenosis (AS)?

What is caused by extension of calcification into the conduction system in aortic stenosis (AS)?

What are the benefits of serial electrocardiographs (ECGs) in the diagnosis of aortic stenosis (AS)?

What is the role of B-type natriuretic peptide (BNP) measurement in the evaluation of aortic stenosis (AS)?

Treatment

What is the treatment options for aortic stenosis (AS)?

What are the ACC treatment recommendations for aortic stenosis (AS)?

What is the role of medical treatment for aortic stenosis (AS)?

What is the role of valve replacement in asymptomatic severe aortic stenosis (AS)?

What is the focus of prehospital and emergency department management for aortic stenosis (AS)?

How is uncontrolled heart failure managed in patients with aortic stenosis (AS)?

How is angina pectoris managed in patients with aortic stenosis (AS)?

How is syncope managed in patients with aortic stenosis (AS)?

How is atrial fibrillation (Afib) managed in patients with aortic stenosis (AS)?

What is the role of percutaneous balloon valvuloplasty in the treatment of aortic stenosis (AS)?

When is valvuloplasty considered in the treatment of aortic stenosis?

What is the mortality rate of percutaneous balloon valvuloplasty for the treatment of aortic stenosis (AS) receiving?

What is the mortality rate of percutaneous balloon valvuloplasty in patients with congenital aortic stenosis (AS)?

Which patients have the best results following valvuloplasty for aortic stenosis (AS)?

What is the rate or restenosis in aortic stenosis (AS) treated with percutaneous balloon valvuloplasty?

What is the surgery of choice for aortic stenosis (AS)?

What determines the type of aortic valve prosthesis in aortic stenosis (AS)?

Which factors increase the risk of operative mortality in patients with aortic stenosis (AS) receiving an aortic valve replacement?

What are the risk factors for late death in patients with aortic stenosis (AS) receiving an aortic valve replacement?

What is the Ross procedure for the treatment of aortic stenosis (AS)?

What is the role of percutaneous transcatheter aortic-valve replacement (TAVR) in the treatment of aortic stenosis (AS)?

What is the incidence of stroke after treatment for aortic stenosis (AS)?

What is the efficacy of percutaneous transcatheter aortic-valve replacement (TAVR) for the treatment of aortic stenosis (AS)?

Which factors are predictors of mortality following percutaneous transcatheter aortic-valve replacement (TAVR) for aortic stenosis (AS)?

Which factors are predictors of mortality following surgical aortic valve replacement (SAVR) for aortic stenosis (AS)?

How do the 5-year treatment outcomes aortic stenosis (AS) vary between percutaneous transcatheter aortic-valve replacement (TAVR) and surgical aortic valve replacement (SAVR)?

What are the survival rates for percutaneous transcatheter aortic-valve replacement (TAVR) for the treatment of aortic stenosis (AS)?

What is the role of self-expanding transcatheter aortic-valve bioprosthesis (CoreValve) for the treatment of aortic stenosis (AS)?

What is the efficacy of the self-expanding transcatheter aortic-valve bioprosthesis (CoreValve) in the treatment of aortic stenosis (AS)?

What are the possible complications of balloon-expandable and self-expandable TAVR in the treatment of aortic stenosis (AS)?

What are the medical treatment options for aortic stenosis (AS)?

What is the role of vasodilators used in the treatment of aortic stenosis (AS)?

How is severe hypertension treated in patients with aortic stenosis (AS)?

What are the ESC/EACTS recommendations for management of heart failure symptoms in patients with aortic stenosis (AS)?

When is prophylaxis for the prevention of bacterial endocarditis indicated in patients with aortic stenosis (AS)?

What activity modifications are needed in patients with aortic stenosis (AS)?

How is aortic stenosis (AS) prevented?

What are possible complications of aortic stenosis (AS)?

Which specialist consultations are required for the treatment of aortic stenosis (AS)?

What should be the frequency of follow-visits in patients with asymptomatic aortic stenosis (AS)?

What should be the frequency of follow-visits in patients with mild aortic stenosis (AS)?

What should be the frequency of follow-visits in patients with moderate of severe aortic stenosis (AS)?

How should patients with moderate or severe aortic stenosis (AS) be monitored?

What long-term care is needed following placement of mechanical valves for treatment of aortic stenosis (AS)?

Guidelines

Which organizations have published treatment guidelines for aortic stenosis (AS)?

How does the AHA/ACC classify the stages of aortic stenosis?

What are the ESC/EACTS criteria for severe aortic stenosis (AS)?

What are the AHA/ACC guidelines for assessing risk in patients with aortic stenosis?

What are the multisociety guidelines for aortic stenosis (AS)?

What are the ESC/EACTS guidelines for valve replacement in patients with aortic stenosis?

How do the recommendations for surgical and transcatheter intervention for aortic stenosis (AS) compare?

What is the ACCF/AHA/HRS recommendation for the use of dabigatran in patients with atrial fibrillation and mechanical valves?

Medications

What is the role of medications in the treatment of aortic stenosis (AS)?

Which medications in the drug class Opioid Analgesics are used in the treatment of Aortic Stenosis?

Which medications in the drug class Angiotensin-converting Enzyme (ace) Inhibitor are used in the treatment of Aortic Stenosis?

Which medications in the drug class Loop Diuretics are used in the treatment of Aortic Stenosis?

Which medications in the drug class Cardiac Glycoside are used in the treatment of Aortic Stenosis?

Which medications in the drug class Beta-Adrenergic Receptor Blockers are used in the treatment of Aortic Stenosis?