Aortic stenosis: diagnosis and management

#### What you need to know The overall prevalence of clinically significant aortic stenosis in patients >70 years old in Europe is approximately 1-3%, making it the most common valvular heart diseases in developed countries.1 2 3 4 Aortic stenosis is a narrowing of the aortic valve that results in restricted blood flow to the body and eventually compromised heart function. Aortic sclerosis is the thickening and calcification of aortic leaflets without motion restriction (fig 1⇓). Aortic sclerosis affects one in four of patients >65 years old in developed countries. Fig 1  Anatomy and function of the aortic valve. The valve controls blood flow from the heart by allowing unobstructed forward flow during systole and preventing blood return to the heart during diastole. It is made of three leaflets in most patients. In aortic stenosis, calcific degeneration of the aortic leaflets reduces opening and prevents full closure This review describes the causes, pathophysiology, presentation, and treatment of aortic stenosis.1 2 3 4 Calcific degeneration of aortic leaflets is the most common cause of aortic stenosis in patients >70 years old in developed countries. The leading cause of aortic stenosis in younger patients is bicuspid aortic valve. This is a congenital abnormality in which the valve is made of two leaflets rather than the normal three leaflet configuration and occurs in 1-2% of the general population in developed countries. Other causes are listed in box 1.2 3 5 #### Box 1: Causes of aortic stenosis Degenerative changes …