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Aortic Stenosis


Step 1: View clinicals

A 68 year old man is referred for evaluation of a heart murmur discovered at a routine checkup. Initially, he claims to be asymptomatic. However, further questioning reveals a slight decrease in exercise capacity which he attributes to "old age". His medical and drug histories are unremarkable.

Step 2: Order all relevant investigations


The ECG appears normal.

Chest X ray

The x-ray appears normal.


There is moderate aortic stenosis with an increased transvalvular pressure gradient and decreased transaortic flow velocity. Left ventricular hypertrophy is noted, while the ejection fraction is 60%.

Coronary Angiography

Coronary angiography shows a pristine coronary vasculature, with a right dominant circulation.

Step 3: Select appropriate management

Aortic Valve Replacement
Endocarditis Prophylaxis

Score: ★★☆