title: Challenges in the echocardiographic assessment of aortic stenosis.
abstract: Calcific aortic valve stenosis is common in the elderly. While history and examination can establish the diagnosis, determination of its severity typically requires echocardiography to define valve anatomy, measure stenosis severity and assess left ventricular response. The purpose of this review is to describe some of the commonly encountered challenges in the echocardiographic assessment of aortic stenosis. These include errors in the calculation of aortic valve area, assessment of aortic stenosis during atrial fibrillation, determining the presence of aortic stenosis in the setting of low transvalvular pressure gradients and discriminating other forms of obstruction to left ventricular ejection from aortic stenosis. Lastly, a review of how echocardiography is utilized to select patients for transcatheter aortic valve replacement is presented.
authors.affiliation: Cardiac Ultrasound Laboratory, Division of Cardiology, Department of Medicine, Massachusetts General Hospital & Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Asaad A
authors.initials: AA
authors.lastname: Khan
authors.forename: Michael H
authors.initials: MH
authors.lastname: Picard
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000601:surgery; D003951:Diagnostic Errors; D004452:Echocardiography; D006801:Humans; D018579:Patient Selection; D065467:Transcatheter Aortic Valve Replacement
keywords: aortic stenosis; echocardiography; low-gradient aortic stenosis; review; transcatheter aortic valve replacement