title: Hemodynamic evaluation of suspected severe aortic stenosis leads to a diagnosis of renal cell carcinoma.
abstract: The evaluation of aortic stenosis is not always straightforward. When symptoms of severe aortic stenosis are present with supporting Doppler echocardiographic or cardiac catheterization data, replacement of the aortic valve is recommended. Occasionally, Doppler- and catheter-derived data are discordant; appropriate treatment in such cases becomes less clear. We report a case in which a 66-year-old man's symptoms and Doppler data suggested severe aortic stenosis. However, heart catheterization data suggested otherwise, and ultimately it led to the diagnosis of a highly vascular renal tumor. Shunting within the tumor resulted in high cardiac output, which, in combination with a small aortic root, masqueraded as severe aortic stenosis.
authors: Mikhailia
authors: M
authors: Lake
authors: Tanyanan
authors: T
authors: Tanawuttiwat
authors: Martin
authors: M
authors: Bilsker
authors: Eduardo
authors: E
authors: De Marchena
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000503:physiopathology; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006328:Cardiac Catheterization; D002302:Cardiac Output; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D009392:Nephrectomy; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Aortic valve stenosis/classification/diagnosis/physiopathology; blood flow velocity; cardiac catheterization/diagnostic; cardiac shunt/evaluation; echocardiography, Doppler