Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • dyspnea
  • chest pain
  • syncope
  • ejection systolic murmur
  • S2 diminished and single
  • carotid parvus et tardus

Other diagnostic factors

  • paradoxically split S2
  • Gallavardin phenomenon
  • bleeding

Risk factors

  • age >60 years
  • congenitally bicuspid aortic valve
  • rheumatic heart disease
  • chronic kidney disease
  • radiation therapy
  • high LDL-cholesterol
  • hyperlipoproteinemia

Diagnostic investigations

1st investigations to order

  • transthoracic echocardiogram (including Doppler)
  • ECG
Full details

Investigations to consider

  • cardiac MRI
  • cardiac catheterization
  • ECG exercise stress testing
  • dobutamine stress echo
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor of Medicine

Emory University School of Medicine

Atlanta

GA

Disclosures

GLK declares that he has no competing interests.

Associate Professor of Medicine

Division of Cardiology

Emory University School of Medicine

Atlanta

GA

Disclosures

VB is a co-investigator in the PARTNER trial, and he has served as a consultant for Edwards Lifesciences and Abbott Vascular.

Professor of Medicine, Pediatrics, and Public Health

Emory University School of Medicine

Atlanta

GA

Disclosures

RMP declares that she has no competing interests.

Dr Girish L. Kalra, Dr Vasilis Babaliaros, and Dr Ruth M. Parker would like to gratefully acknowledge Dr David Liff, a previous contributor to this monograph. DL declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Medicine

Emory University School of Medicine

Atlanta

GA

Disclosures

PB declares that he has no competing interests.

Consultant Cardiologist and Honorary Senior Lecturer

Imperial College Healthcare NHS Trust

Hammersmith Hospital

London

UK

Disclosures

GM has been supported by Edwards Lifesciences (manufacturer of the Edwards Sapien Transcatheter Valve) for attending cardiology conferences. Both Edwards Lifesciences and Medtronic (manufacturer of the CoreValve Transcatheter Valve) are contributing to an educational course on the transcatheter and surgical treatments of aortic and mitral valve disease. Edwards Lifesciences are supporting a research project on transcatheter treatment of aortic valve disease.

Consultant

Cardiology Center

University Hospital Geneva

Geneva

Switzerland

Disclosures

JMS declares that he has no competing interests.

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