Aortic stenosis echocardiography

Aortic Stenosis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Aortic Stenosis from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Cardiac Stress Test
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography
Cardiac Catheterization
Aortic Valve Area
Aortic Valve Area Calculation
Treatment
General Approach
Medical Therapy
Surgery
Percutaneous Aortic Balloon Valvotomy (PABV) or Aortic Valvuloplasty
Transcatheter Aortic Valve Replacement (TAVR) TAVR vs SAVR Critical Pathway Patient Selection Imaging Evaluation Valve Types TAVR Procedure Post TAVR management AHA/ACC Guideline Recommendations
Follow Up
Prevention
Precautions and Prophylaxis
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Aortic stenosis echocardiography On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Aortic stenosis echocardiography All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Aortic stenosis echocardiography
CDC on Aortic stenosis echocardiography
Aortic stenosis echocardiography in the news
Blogs on Aortic stenosis echocardiography
Directions to Hospitals Treating Aortic stenosis echocardiography
Risk calculators and risk factors for Aortic stenosis echocardiography

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2]; Abdul-Rahman Arabi, M.D. [3]; Keri Shafer, M.D. [4]

Overview

Echocardiography may be used as a diagnostic tool in the evaluation of aortic stenosis. As an evaluative tool, echocardiograms can identify functionality issues within the heart's anatomy. An aortic stenosis patient will present symptomatic evidence of a pressure gradient, the result of left ventricular hypertrophy.

Echocardiogram

Echocardiogram (heart ultrasound) is the best non-invasive test to evaluate the aortic valve anatomy and function.

The aortic valve area can be calculated non-invasively using echocardiographic flow velocities. Using the velocity of the blood through the valve, the pressure gradient across can be calculated by the equation:

Gradient = 4(velocity)² mmHg

A normal aortic valve has no gradient. If the mean gradient is <25 mm Hg, the stenosis is mild; if the mean gradient is between 25 mm Hg and 50 mm Hg, the stenosis is moderate; if the mean gradient is >50 mm Hg the stenosis is severe; and when the gradient is greater than 70 mm Hg, the stenosis is critical. A normal aortic valve area is >2 cm². If the valve area is between 1.3 and 2.0 cm², the stenosis is mild; if the valve area is between 1.0 and 1.3 cm², the stenosis is moderate; if the valve area is between 0.7 and 1.0 cm², the stenosis is moderate-severe; areas of less than 0.7 cm² constitute severe aortic stenosis.

2D echocardiography of the aortic valve in the parasternal long axis view demonstrates right and non coronary leaflets. In the parasternal short axis view, leaflets open equally and forms a circular orifice during systole. During diastole, the normal leaflets form a three pointed star with prominence at the closing point. (nodules of Arentius)