Clinical features that help in assessing the severity of
aortic stenosis are
1.
Pulse
2.
Split
of S2
3.
S4
4.
Length
of murmur
5.
Peaking
of murmur
6.
Loudness
of murmur
7.
Thrill
Severity is based on
1.
Splitting
of S2
Mild AS - A2is followed by P2
Moderate AS - A2 is delayed resulting in single S2
Severe AS - P2 - A2 reverse splitting of S2
2.
Presence
of S4 and absent A2
3.
Presence
of S3
4.
Long
murmur and late peaking of murmur
5.
According
to valve surface area
6.
According
to gradient across the valve
Severity
|
Features
|
Mild AS
|
Murmur
|
Moderate AS
|
1.
Anacrotic pulse
2.
Thrill
3.
Long murmur
4.
Loud murmur
5.
Late peaking
|
Severe
|
1.
Anacrotic pulse
2.
Thrill
3.
Long murmur
4.
Late peaking
5.
Loud murmur
6.
Paradoxic split
7.
LVS4
|
Severity based on
valve area
1.
Normal
valve area : 2.5 – 3.5cm2
2.
Tight
(critical AS ) : <0.5cm2 / m2 body
surface are -0.8cm.
Severity of AS based
on hemodynamic gradient
It is based on gradient across the valve
1.
Mild
AS : 25-50mm Hg
2.
Moderate
AS : 50-75mmHg
3.
Severe
AS : >75mm/Hg
Severity of aortic
stenosis is assessed with
1.
Low
volume slow raising pulse
2.
Systolic
decapitation of blood pressure
3.
Paradoxical
splitting of S2
4.
Presence
of S4
5.
If
there is absent thrill is it is against a severe stenosis.
Read related topics - Aortic Stenosis
- Heart sounds in Aortic stenosis
- Pulse in aortic stenosis
- Differentiate between valvular, supravalvular, subvalvular aortic stenosis
- What are the clinical examination findings in Aortic Stenosis
- Symptoms of aortic stenosis
- What are the causes of aortic stenosis
- Medical treatment in aortic stenosis
- Aortic stenosis correlation of clinical finding and pathogenesis
- Murmur of Aortic stenosis
- Heart sounds and murmur in Aortic stenosis
- Pathophysiology of Aortic stenosis
- Causes of Aortic stenosis
