Aortic Stenosis

N C Joshi
Consultant Pediatrician, Nanavati Hospital, Mumbai, India
First Created: 01/08/2001 

Aortic Stenosis Types

  • Valvular: bicuspid valve

  • Subvalvular: Membrane (discrete), Long tunnel, IHSS

Anatomical types of aortic stenosis (Figure 1)

  • normal
  • valvular stenosis
  • supravalvular stenosis
  • discrete subaortic stenosis
  • IHSS


types of aortic stenosis

M:F=4:1

Aortic Stenosis - Clinical Manifestations

  • Most are asymptomatic

  • Severe cases: CHF, exertional chest pain, syncope

Physical Examination:

  • Acyanotic

  • Narrow pulse pressure. Higher BP in the right arm than the left in supravalvular AS

  • Systolic thrill with murmur at RUSB, suprasternal notch and over the carotid arteries

  • Early ejection systolic click with valvular AS

Figure 2: Cardiac findings of aortic valve stenosis. Abnormal sounds are indicated in black. The systolic thrill may be present in areas with dots.


Cardiac findings of aortic valve stenosis

Aortic Stenosis - Investigations

ECG: Normal even in severe cases or LVH with strain

Chest X-ray: Heart size > normal with dilated ascending aorta

Aortic Stenosis - Treatment

  • Aortic valve commissurotomy: When peak gradient >50 mmHg or valve area <0.5 cm2/m2

  • Membrane excision

  • Myectomy - For Tunnel sub aortic stenosis & IHSS

  • Fabric patch- Supravalvular


Aortic Stenosis Aortic Stenosis Aortic Stenosis 01/08/2001
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