Aortic Valve Stenosis !
Aortic valve stenosis is a narrowing of the valve between the heart and the aorta, which makes the left ventricle work harder to pump blood out.
Updated 2026-10-23
Structures involved
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In embryology
In the clinical exam
- Precordial inspection and palpation: apex beat, heaves and thrills
- Cardiac auscultation: the areas and the order
- Heart sounds: S1, S2 and its splitting, S3 and S4
- Murmurs: timing, grade, location and radiation
- Valve murmurs: the table to know
- Dynamic auscultation: Valsalva, squatting, standing and handgrip
- Abnormal pulses: paradoxus, alternans, parvus et tardus, bounding
- Chest pain: ischemic, pericardial, pleural and other patterns
In physiology
- The cardiac cycle
- Heart sounds and where they come from
- The ventricular pressure–volume loop
- Systolic, diastolic, mean and pulse pressure
- Preload, afterload and contractility
- Flow, pressure and resistance: Poiseuille and turbulent flow
- Murmurs and the hemodynamics of valve disease
- Coronary circulation and myocardial ischemia
Why it happens
- Pathologic calcification: dystrophic vs metastatic
- Hypertrophy: physiologic and pathologic
- How organs age: normal changes vs disease
- The heart wall, valves and conduction tissue
What it is
Narrowing of the aortic valve opening that obstructs blood flow from the left ventricle.
Causes
- Age-related calcification (most common in older adults)
- Bicuspid aortic valve (younger patients)
- Rheumatic disease (still an important cause in Latin America, especially in younger adults)
Symptoms and signs
- Exertional chest pain, shortness of breath, or syncope (classic triad in severe cases)
- May be asymptomatic for years
Diagnosis
- Clinical
- Systolic murmur
- Imaging
- Echocardiography is the key study
Treatment
- Follow-up
- Regular follow-up when mild or asymptomatic.
- Surgical
- Valve replacement (surgical or transcatheter) for severe symptomatic disease.
Related conditions
- Aortic dissection
- Syphilis
- Heart failure
- Stable angina
- Rheumatic heart disease
- Aortic regurgitation
- Coarctation of the aorta
Educational information, not medical advice. For any symptom, see a health professional.
Sources: Aortic Stenosis (StatPearls (NCBI Bookshelf), 2024).
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Representative model, for educational purposes only.
