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The definitive diagnostic test for aortic stenosis is:
- Doppler echocardiography
- Cardiac catheterization
A presumptive diagnosis can be made with:
- Auscultation of a left basilar systolic heart murmur
- Weak femoral arterial pulse
- Weak pulses are noted only in severe cases
- Left ventricular enlargement on ECG and
- Usually LVE is not evident on the ECG
- A bulge in the ascending aorta on radiography
- Usually in ascending aortic bulge is not evident on the radiographs
Radiology may see:
- left ventricular enlargement
- dilation of the aortic arch particularly on the lateral view in the region of the “right auricle/main pulmonary artery /ascending aorta”
- frequently radiographs are normal
ECG:
- usually normal
- may see criteria of left ventricular enlargement
- may see ventricular ectopy (PVC’s)
Echocardiography:
- left ventricular hypertrophy (concentric)
- subvalvular lesion in the left ventricular outflow tract
- increased velocity across the aortic valve by Doppler
- Not only does this data provide a diagnosis but it remains the most critical data to address severity of the stenosis
- aortic regurgitation by Doppler in about 85% of cases