Abstract
This chapter discusses the auscultation findings and fundamental clinical aspects of aortic stenosis including causes, diagnostic indicators, pathophysiology and treatment options. Aortic stenosis is a crescendo-decrescendo systolic ejection murmur with ejection click heard best at the base of the heart. The pathophysiology of aortic stenosis includes progressive stenosis over time due to calcification. This stenosis leads to an increased pressure gradient across the valve over time with a subsequently decreased ejection fraction. The decreased ejection fraction causes compensatory hypertrophic changes in the heart and leads to clinical symptoms including angina, syncope and heart failure. Treatment options for patients with aortic stenosis differ depending on a variety of factors including age, underlying cause, presence or absence of symptoms and symptom severity.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Phoon CK. Estimation of pressure gradients by auscultation: an innovative and accurate physical examination technique. Am Heart J. 2001;141(3):500–6.
Brown J, Shah P, Stanton T, Marwick TH. Interaction and prognostic effects of left ventricular diastolic dysfunction and patient-prosthesis mismatch as determinants of outcome after isolated aortic valve replacement. Am J Cardiol. 2009;104(5):707–12.
Otto CM, Burwash IG, Legget ME, et al. Prospective study of asymptomatic valvular aortic stenosis. Clinical, echocardiographic, and exercise predictors of outcome. Circulation. 1997;95(9):2262–70.
Munt B, Legget ME, Kraft CD, Miyake-Hull CY, Fujioka M, Otto CM. Physical examination in valvular aortic stenosis: correlation with stenosis severity and prediction of clinical outcome. Am Heart J. 1999;137(2):298–306.
Pibarot P, Dumesnil JG. New concepts in valvular hemodynamics: implications for diagnosis and treatment of aortic stenosis. Can J Cardiol. 2007;23:40B–7.
Bonow RO, Carabello BA, Chatterjee K, et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(13):e1–142.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
1 Electronic Supplementary Material
Video 5.1
Example of moderate aortic stenosis: 60 mmHg peak gradient (Provided by Robin Winkler Doroshow, MD, Medstar Georgetown University Hospital, Washington, DC) (MP4 1106 kb)
Video 5.2
73-year-old-man with severe AS as described by Dr. W. Proctor Harvey (File 198 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 5791 kb)
Rights and permissions
Copyright information
© 2015 Springer-Verlag London
About this chapter
Cite this chapter
Kammel, J.M., Bence, C.M., Money, A.J., Swinford, S.T. (2015). Aortic Stenosis. In: Taylor, A. (eds) Learning Cardiac Auscultation. Springer, London. https://doi.org/10.1007/978-1-4471-6738-9_5
Download citation
DOI: https://doi.org/10.1007/978-1-4471-6738-9_5
Publisher Name: Springer, London
Print ISBN: 978-1-4471-6737-2
Online ISBN: 978-1-4471-6738-9
eBook Packages: MedicineMedicine (R0)