Narrowing of the aortic valve, affecting blood flow in the heart

Classified as congenital, acquired, or rheumatic

With congenital heart disease, symptoms possibly absent until adulthood, even though stenosis has been present since childhood

About 80% of patients male

Stenosis of the aortic valve results in impeded blood flow.

The left ventricle requires greater pressure to open the aortic valve.

This added workload increases myocardial oxygen demands.

Diminished cardiac output reduces coronary artery blood flow.

Left ventricular hypertrophy and failure results.

Congenital aortic bicuspid valve

Idiopathic fibrosis and calcification

Rheumatic fever

May be asymptomatic

History possibly including dyspnea on exertion, dizziness, angina, exertional syncope, fatigue, palpitations, and paroxysmal nocturnal dyspnea

Small, sustained arterial pulses slowly rising

Distinct lagging between carotid artery pulse and apical pulse

Orthopnea

Prominent jugular vein A waves

Peripheral edema

Diminishing carotid pulses with delayed upstroke

Apex of the heart possibly displaced inferiorly and laterally

Suprasternal thrill

Blood pressure may be normal