- Obstruction in flow from ventricle to aorta due to failure of valve leaflets to open appropriately
- Can occur due to calcification of normal tri-leaflet valve (senile calcific) or from calcification of congenital bicuspid valve
- Adult calcific (tri-leaflet) age >70
- Bicuspid age > 40
- Rheumatic heart disease
- Initially asx, then can have SOB, syncope, chest pain, chf as stenosis worsens
- Crescendo-descrendo systolic murmur
- Loudest upper sternal borders, though often audible across precordium
- Radiates to carotids and R clavicle
- Later peaking as progresses
- With severe disease, loss of A2
- CHF findings can occur in advanced disease
- Echo very helpful in identifying cause, determining valve area, trans valvular gradient and LV function