Arq Bras Cardiol: Imagem cardiovasc. 2022; 35(1): ecom21
My Approach to Aortic Stenosis Assessment with Discrepant Quantification
DOI: 10.47593/2675-312X/20223501ecom21
Introduction
Aortic stenosis (AS) is the most common primary valve disease and an important cause of morbidity and mortality worldwide. Echocardiography is the first-line method for its diagnosis, quantification of severity, prognosis, and determination of intervention timing.
The association of maximum velocity (Vmax) ≥ 4m/s, aortic valve area (AVA) ≤ 1.0 cm², and mean gradient (MG) ≥ 40 mmHg defines the diagnosis of classic severe AS. However, MG and AVA are discrepant (AVA ≤ 1.0 cm², MG < 40 mmHg) in 30–40% of the population with severe AS, leading to low-gradient AS (LGAS), the focus of this article. Less frequently, high-gradient AS can also occur in cases of MG ≥ 40 mmHg and AVA > 1.0 cm² due to high flow situations.
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Keywords: Aortic Stenosis; Diagnosis; Echocardiography
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