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 low-density lipoprotein (LDL)-cholesterol
- hyperlipoproteinemia
Diagnostic investigations
1st investigations to order
- transthoracic echocardiogram (including Doppler)
- ECG
Investigations to consider
- cardiac MRI
- cardiac catheterization
- ECG exercise stress testing
- dobutamine stress echo
Treatment algorithm
Contributors
Authors
Assistant Professor of Medicine
Emory University School of Medicine
Atlanta
GA
Disclosures
GLK declares that he has no competing interests.
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 topic.
Peer reviewers
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.
Use of this content is subject to our disclaimer