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Can severity of aortic stenosis be determined despite absent contractile reserve in low-flow low-gradient aortic
Anastasia Vamvakidou1, Benoy N Shah2, Roxy Senior3,4,5
1Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow, United Kingdom.
Abstract:
A 79-year-old man presented with increasing breathlessness and his echocardiogram revealed severe left ventricular systolic dysfunction and low-flow low-gradient aortic stenosis. Low-dose dobutamine stress echocardiography revealed the absence of contractile reserve (increase of stroke volume by ≥20% did not occur). The test would have therefore been inconclusive. However, the attainment of normal flow (FR≥200 mL/s) during dobutamine stress enabled the diagnosis of true severe aortic stenosis.
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