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Related Concept Videos

Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Updated: Nov 9, 2025

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Outcomes in asymptomatic, severe aortic stenosis.

Anette Borger Kvaslerud1,2,3, Kenan Santic1, Amjad Iqbal Hussain2,3

  • 1Faculty of Medicine, University of Oslo, Oslo, Norway.

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Summary

Patients with severe aortic stenosis who are asymptomatic have a higher mortality risk than those undergoing aortic valve replacement. This study highlights the need to re-evaluate conservative management for severe aortic stenosis.

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Area of Science:

  • Cardiology
  • Clinical Medicine
  • Medical Research

Background:

  • Severe aortic stenosis in asymptomatic patients is often presumed to have a benign prognosis.
  • Contemporary management strategies for these patients are not well-defined.
  • This study investigates the natural history of asymptomatic severe aortic stenosis.

Purpose of the Study:

  • To examine the natural history of contemporary patients with severe aortic stenosis who were advised against aortic valve replacement due to a perceived lack of symptoms.
  • To compare the outcomes of asymptomatic severe aortic stenosis patients with those undergoing aortic valve replacement.

Main Methods:

  • Retrospective cohort study of patients with severe aortic stenosis (ICD-10 code I35.0) at Oslo University Hospital.
  • Comparison of 114 asymptomatic patients with 100 age and gender-matched patients scheduled for aortic valve replacement.
  • Data collection included baseline characteristics, adverse events, and survival rates.

Main Results:

  • Asymptomatic patients (n=114) exhibited significantly higher mortality than those who had aortic valve replacement (log-rank p<0.001).
  • 1-year, 2-year, and 3-year survival rates were 88%, 75%, and 63% for asymptomatic patients, versus 92%, 83%, and 78% for the surgical group.
  • Age, coronary artery disease history, and NT-proBNP levels predicted mortality and morbidity in asymptomatic patients.

Conclusions:

  • Asymptomatic patients with severe aortic stenosis who do not undergo surgery face significantly higher mortality.
  • Conservative management for severe aortic stenosis in asymptomatic individuals may not be associated with a benign prognosis.
  • Further research is needed to optimize treatment strategies for this patient group.