Aortic Sclerosis

  • Armond Esmaili
  • Robert A. Christian
  • Ashley C. Pfaff


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.


Aortic valve sclerosis Valve thickening ‘50–50’ murmur Systolic ejection flow murmur Echocardiography diagnosis Aortic stenosis precursor lesion Aortic valve area Coronary artery disease marker 

Supplementary material

310603_1_En_4_MOESM1_ESM.mp4 (9.7 mb)
Video 4.1 70-year-old-man with mild AS as described by Dr. W. Proctor Harvey (File 197 from Clinical Cardiology by W. Proctor Harvey, MD, MACC, Jules Bedynek, MD, and David Canfield and published by Laennec Publishing Inc., Fairfield, NJ. Used with permission and copyrighted by Laennec Publishing, Inc. All rights reserved.) (MP4 9882 kb)


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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  • Armond Esmaili
    • 1
  • Robert A. Christian
    • 1
  • Ashley C. Pfaff
    • 1
  1. 1.Georgetown University School of Medicine, Georgetown University HospitalWashingtonUSA

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