Fast Five Quiz: Aortic Stenosis

Yasmine S. Ali, MD

Disclosures

June 25, 2019

Multimodality imaging is essential for preoperative planning and postoperative detection of potential complications. Two-dimensional and Doppler echocardiography is the imaging modality of choice to diagnose and determine the severity of aortic stenosis.

In general, cardiac catheterization is not necessary to determine the severity of aortic stenosis. However, in instances in which clinical findings are not consistent with echocardiogram results, cardiac catheterization is recommended for further hemodynamic assessment.

Exercise stress testing is contraindicated in symptomatic patients with severe aortic stenosis, but it may be considered in asymptomatic patients with severe aortic stenosis. In asymptomatic patients, stress testing has been shown to be a low-risk procedure when it is performed under strict surveillance.

In general, ECG is not a reliable test for aortic stenosis. The results widely vary in patients with this disorder, and overlap with other cardiac conditions. Although the ECG findings may be entirely normal, the principal finding is left ventricular hypertrophy, which is found in most patients with severe aortic stenosis; however, its absence does not preclude critical aortic stenosis. Patients with significant aortic stenosis who may not show clear ECG evidence of ventricular hypertrophy include elderly persons with significant myocardial fibrosis and adolescents who may experience ST-segment changes before QRS changes.

Read more on the workup of aortic stenosis.

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