How does aortic stenosis
affect the aortic valve?
A patient with aortic stenosis will experience calcification, lipid deposition, and inflammatory
infiltration of the aortic valve leaflets. Over time, these leaflets become increasingly stiff, leading to a
narrowing of the heart valve opening, obstructing blood flow and forcing the heart to pump harder.2
How common is aortic stenosis?
In order to understand the prevalence of the disease,
please enter an estimate of the number of patients over 75 you see per week:
Elderly patients you see per year who might suffer from AS4
Patients who might have moderate or severe AS5
Patients who might not survive past 2 years if severe AS left untreated6
It is likely that these numbers will only increase as
populations continue to age. How many patients
have you suspected of aortic stenosis?
Public awareness of aortic stenosis is extremely low.
94% of the over 60s
in the UK do not know
what aortic stenosis is.8
This is why your role, as a primary care physician,
is so important in optimally diagnosing these patients.
Once symptoms appear in patients with severe AS, life expectancy
is severely reduced.3
Aortic stenosis can be latent in patients for a number of years, but once symptoms manifest life expectancy is significantly reduced.9
The murmur typically associated with aortic stenosis is a harsh systolic
ejection murmur, with a single or paradoxically split second heart sound.
Listen below to compare this to a normal heartbeat.
Sound recording courtesy of Thinklabs. Recorded on a Thinklabs stethoscope.
To support you in your practice a number of aortic stenosis educational materials have been developed, including materials to support patient consultation. All resources can be posted directly to your practice and are provided at no charge.
Exploring Aortic Stenosis: a primary and secondary care perspective
Listen to this conversation between a Cardiologist and a GP about the patient pathway of AS patients. In the beginning, the cardiologist asks the GP about the suspicion of AS in primary care, checks, and subsequent steps. Then, the conversation switches to the GP asking the cardiologist about the handling of patients referred with a suspicion of AS and the decision on their treatment options.
Speakers: Dr. Chris Young (Cardiac surgeon, St Thomas’ Hospital, London) and Dr. Chris Arden (GP, Chandlers Ford, Hampshire)
Accredited podcast with 0.5 educational points.
Listen, Suspect, Refer: A guide to detecting heart valve disease
Interactive eLearning module in partnership with the Royal College of General Practitioners and Dr Yassir Javaid, aiming to equip primary care physicians with the skills to detect and refer patients with valvular heart disease.
Duration: 30 minutes
Accredited module with 0.5 educational points.
- Bouma BJ, van den Brink RBA, van der Meulen JHP et al. To operate or not on elderly patients with aortic stenosis: the decision and its consequences. Heart 1999 Aug; 82: 143–8.
- Grimard BH, Larson JM. Aortic Stenosis: diagnosis and treatment. Am Fam Physician 2008;78:717–24
- Otto CM. Timing of aortic valve surgery. Heart 2000;84:211–218
- Based on a 48 week working year. Number calculated from pooled prevalence of all AS in the elderly (12.4%). Ref: Osnabrugge RLJ, Mylotte D, Head SJ et al. Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling Study. J Am Coll Cardiol. 2013;62:1002–
- Osnabrugge RLJ, Mylotte D, Head SJ et al. Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling Study. J Am Coll Cardiol. 2013;62:1002–12.
- Otto CM. Timing of aortic valve surgery. Heart 2000; 84:211-–218
- Alliance for Aging Research. Aortic Stenosis: Under-Diagnosed and Under-Treated. 2010. https://www.agingresearch.or/newsletters/view/36. Accessed August 12, 2016
- Gaede L, Di Bartolomeo R, van der Kley F et al. Aortic valve stenosis – what do people know? A Heart Valve Disease Awareness Survey of over 8,800 people aged 60 or over. Eurointervention: Journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2016;12:883–9.
- Carabello BA. Introduction to aortic stenosis. Circ Res 2013;113:179–85
- Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS), Baumgartner H, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease (version 2017). Eur Heart J 2017;38:2739–91
- Dr Wern Yew Ding, Dr Unni Krishnan. Aortic Valve disease: Clinical Review. GP Online. 2016. http://www.gponline.com/aortic-valve-disease-clinical-review/cardiovascular-system/article/990063 . Accessed March 13th, 2017.
- Nishimura RA, Otto CM, Bonow RO et al. 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: Executive summary. Circulation 2014; 10;129:2440–92.