Aortic Stenosis
Cardiovascular · ~11% of blueprint- Pathophysiology
- Progressive valve calcification/fibrosis (or congenital bicuspid valve) → ↓ valve area → LV outflow obstruction → pressure-overload LVH.
- Signs & Symptoms
- Triad: Angina, Syncope, Dyspnea (exertional). Harsh crescendo-decrescendo systolic murmur at R 2nd ICS radiating to carotids; pulsus parvus et tardus.
- Gold Standard Diagnosis
- Echocardiography (valve area, mean gradient, EF). Severe: area ≤1.0 cm², mean gradient ≥40 mmHg, Vmax ≥4 m/s.
- First-line Treatment
- Valve replacement (SAVR or TAVR) once symptomatic or severe with ↓EF. No medical therapy halts progression; avoid aggressive afterload reduction/diuresis.
High-Yield Pearl
Symptom onset (angina → syncope → HF) marks a sharp drop in survival → refer for replacement. Bicuspid valve = AS in younger patients.
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Gross Anatomy
Physiology
Sources
Reviewed September 2026- 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease — ACC/AHA, 2020
- StatPearls: Aortic Stenosis — NCBI Bookshelf / StatPearls, 2025
- StatPearls: Mechanical Aortic Valve Replacement — NCBI Bookshelf / StatPearls, 2025
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