Learning on the Web. Case 8: systolic murmur in an asymptomatic 70 year old man.

Abstract

A 70 year old man with hypertension underwent echocardiography for an asymptomatic murmur and was found to have aortic valve sclerosis. Over the next eight years, annual echocardiography showed progressive valve calcification with an increase in transaortic velocity and pressure gradient and a decrease in valve area. He eventually developed decreased exercise tolerance and was referred for aortic valve replacement. The purpose of this interactive case presentation is to illustrate the diagnosis and clinical implications of aortic valve sclerosis and the progression of sclerosis to significant stenosis, and its appropriate diagnosis and management.