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Case Details

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Aortic Stenosis

  • Author: Dr. Hasan Altarrah
  • Published Date: 13/05/2026
  • Last Modified Date:
  • Rating :
  • Reviews: ( 0 Reviews )
  • Category :Internal Medicine
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Additional Information:

  • CC: SOB | Examine the heart

Description

Clinical Signs
  • Ejection systolic murmur heard on the right side and radiating to carotids
  • Apex beat sustained (heaving)
  • Thrill in right second intercostal space
  • Carotid pulse delayed and diminished (Parvus et tardus)
Differential Diagnosis
  • HOCM
  • VSD
  • Murmurs of pregnancy and anemia
Causes
  • Congenital (Bicuspid valve)
  • Rheumatic
  • Aortic sclerosis
  • Calcification
Symptoms of Aortic Stenosis
  • Angina
  • Syncope
  • SOB
Severity of AS
  • Delayed ESM
  • S4
  • Soft or absent aortic component of second heart sound
Investigations
  • ECG: LVH
  • Coronary angiography
  • Echo: Severe aortic stenosis (valve area < 1 cm² and mean gradient > 40 mmHg)
Management

Asymptomatic

  • No specific treatment
  • Regular follow-up with echo and good dental hygiene

Symptomatic

  • Surgery

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