Aortic Stenosis

by | 20 May, 2020

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Aortic stenosis refers to abnormal narrowing of the aortic valve. It is one of the most common valve lesions.


Sound: Ejection systolic murmur

Loudest region: Aortic area (Right sternal border at 2nd intercostal space)

Radiation: Carotid artery

Accentuation: Expiration

ejection systolic murmur
Ejection systolic murmur

Ejection systolic murmur. Source: University of Michigan Murmur library


Aortic stenosis
Aortic stenosis as a result of rheumatic heart disease

Differential diagnosis


  • Echocardiogram
  • ECG: may show left ventricular hypertrophy
  • Chest x-ray
  • Blood cultures, if considering infective endocarditis


Asymptomatic patients should be managed conservatively with regular echocardiogram follow-up.

The following patients should be treated surgically:

  • Symptomatic patients
  • Echocardiographic evidence of severe aortic stenosis:
    • <1cm2 aortic valve area
    • Pressure gradient >40 mmHg across the aortic valve



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