title: A review of the pathophysiology, diagnosis, and treatment of aortic valve stenosis in elderly patients.
abstract: Elderly patients experiencing valvular aortic stenosis (AS) show an increased prevalence of coronary risk factors, coronary artery disease, and other atherosclerotic vascular diseases. Angina pectoris, syncope or near syncope, and congestive heart failure are the 3 classic manifestations of severe AS in patients. Prolonged duration and late peaking of an aortic systolic ejection murmur best differentiate severe AS from mild AS upon physical examination of the patient. Doppler echocardiography is used to diagnose the severity of patient AS. In the article, indications for aortic valve replacement (AVR) in patients, the use of warfarin after AVR in patients with mechanical prostheses, and the use of aspirin or warfarin after AVR in patients with bioprosthesis are discussed. Transcatheter aortic valvular replacement should be performed in non-operable patients with symptomatic severe AS to improve their survival and quality of life rather than using regular medical management of the condition.
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, New York. wsaronow@aol.com.
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality / Q000523:psychology / Q000601:surgery; D001241:Aspirin / Q000627:therapeutic use*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D014859:Warfarin; D001241:Aspirin