[Significant aortic stenosis with a low pressure gradient and depressed left ventricular function. A case report]

A 48-year-old man, not diagnosed before, hardly physically working before admission, was admitted to cardiological ward at a regional hospital in bad condition, with severe heart failure symptoms. Massive calcification of the bicuspidal aortic valve was found during the echocardiography examination. Mean systolic aortic gradient was 32 mmHg. Left ventricular ejection fraction was reduced to 20%. The patient was treated with diuretics, digitalis, dobutamine and dopamine infusion but his condition was getting worse. On the 10th day of hospitalisation, he was transferred to cardio-surgical ward and aortic valve was replaced. On the 15th day following operation the patient came back to the regional hospital in good condition. The echocardiography examination revealed an increase in systolic ejection fraction of the left ventricle up to 48% in one month and to 55% in six months after surgery.