Aortic valve sclerosis (AVS) is a common, acquired valvular condition characterized by fibrosis, thickening, and calcification of the aortic cusps without concomitant absence of outflow obstruction. AVS shares similar risk factors to atherosclerosis and is associated with increased risk of coronary artery disease (CAD) and myocardial infarction (MI); AVS may thus be a marker of CAD. AVS has been described as a “50–50 murmur,” meaning that it is present in approximately 50 % of the population at age 50. Auscultation findings include the presence of an early to mid-systolic ejection murmur (often soft), normally split S2, and no click at the 2nd right interspace (aortic valve area). Carotid pulses are normal in cases of AVS and help distinguish AVS from murmurs associated with ventricular outflow obstruction. AVS is not associated with aortic regurgitation; if aortic regurgitation is found on auscultation, AVS as the sole abnormality is likely not present. Due to its similar pathologic appearance to atherosclerosis, coronary risk factor modification could potentially slow AVS progression.
KeywordsAortic valve sclerosis Valve thickening ‘50–50’ murmur Systolic ejection flow murmur Echocardiography diagnosis Aortic stenosis precursor lesion Aortic valve area Coronary artery disease marker
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