Aortic stenosis in elderly people: an evaluation of clinical and echocardiographic diagnosis

In a prospective study to assess the sensitivity and specificity of clinical diagnosis against echocardiographic diagnosis in elderly people, 41 patients were studied in two 6-month periods. Overall clinical and echo diagnosis agreed in 75% of cases, but the clinical diagnosis of aortic stenosis was poor in the initial period. Adapting the lessons which were learnt in this initial period in a repeat of the study, the sensitivity of clinical diagnosis of aortic stenosis improved from 0.38 to 0.75. Additional information was gained in 50% of cases by echocardiography, and enabled the clinician to modify treatment in 50% of cases. Aortic stenosis in elderly people may be without clinical signs. Routine echocardiography increases the sensitivity of the clinical diagnosis, and may have major therapeutic implications for the elderly patient.