Valvular Disease and Heart Failure: Aortic Stenosis

  • Steven Gannon
  • Siddique A. AbbasiEmail author
Part of the Clinical Cases in Cardiology book series (CCC)


A 74 year old male with a past medical history of hypertension, atrial fibrillation on warfarin and moderate aortic stenosis presented with recurrent admissions for decompensated heart failure with preserved ejection fraction. In addition to volume overload the patient complained of severe dyspnea on exertion; he denied exertional angina and syncope. He responded promptly to diuresis each hospitalization and was discharged on escalating doses of oral furosemide and beta-blockers for rate and blood pressure control. Repeat transthoracic echocardiogram demonstrated moderate concentric left ventricular (LV) hypertrophy, small LV size, LV ejection fraction of 60%, aortic valve area (AVA) of 0.5 cm2/m2, mean gradient of 28 mmHg, and stroke volume index of 30 ml/m2. A dobutamine stress echocardiogram showed an increase in LV ejection fraction to 70% with stress in addition to a fixed AVA of 0.5 cm2/m2 and an increase in mean gradient to 32 mmHg. His aortic valve calcium score by multidetector computed tomography was 2146 AU.


Aortic valve stenosis Transcatheter aortic valve replacement 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Brown UniversityProvidenceUSA

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