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The definitive diagnostic test for aortic stenosis is:

  1. Doppler echocardiography
  2. Cardiac catheterization

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


  • usually normal
  • may see criteria of left ventricular enlargement
  • may see ventricular ectopy (PVC’s)


  • 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