Aortic Stenosis - Burden and Echocardiographic Assessment-Aortic Stenosis

Video Transcription

Video Summary

Aortic stenosis is common in older adults, most often due to age-related calcification; bicuspid valves cause earlier disease, while rheumatic disease remains important in lower-income regions. Progressive obstruction causes left ventricular pressure overload, hypertrophy, fibrosis, dysfunction, and eventually heart failure. Symptoms and reduced ejection fraction traditionally prompt valve intervention, while recent trials support early intervention for selected asymptomatic patients.<br /><br />Echocardiographic severity assessment integrates peak velocity, mean gradient, and valve area. Accurate measurements are essential: errors in LVOT diameter or Doppler sample placement can distort valve area, and peak velocity should be assessed from multiple windows. Dimensionless index can help when LVOT measurement is uncertain. For persistent discordance, assess flow and consider dobutamine stress echocardiography or CT valve calcium scoring. Dobutamine distinguishes true severe from pseudo-severe disease in classical low-flow, low-gradient AS; CT calcium scoring is also useful when discordance persists and in paradoxical low-flow, low-gradient AS with preserved ejection fraction.

Meta Tag

Concept Aortic Stenosis

Concept Severe Aortic Stenosis

Concept Cardiac Ultrasound

Concept Aortic Jet Velocity

Concept Mean Transvalvular Pressure Gradient

Keywords

aortic stenosis

echocardiography

valve calcification

low-flow low-gradient

dobutamine stress echocardiography

Aortic Stenosis

Severe Aortic Stenosis

Cardiac Ultrasound

Aortic Jet Velocity

Mean Transvalvular Pressure Gradient