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Published on: September 8, 2023
Diagnostic Challenges in Aortic Stenosis
André González-García1, Pablo Pazos-López1, Francisco Eugenio Calvo-Iglesias1
1Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain.
Aortic stenosis (AS) diagnosis can be challenging, especially with low gradients. A comprehensive multimodality cardiac imaging approach is crucial for accurate assessment and patient management.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Aortic stenosis (AS) is the most common degenerative valvular heart disease in Western countries.
- Transthoracic echocardiography (TTE) is the primary imaging modality for AS due to its accessibility, safety, and cost-effectiveness.
- Accurate AS grading is essential for appropriate patient management.
Purpose of the Study:
- To review the diagnostic challenges in assessing aortic stenosis (AS).
- To highlight the benefits of a comprehensive multimodality cardiac imaging (MCI) approach for precise AS grading.
Main Methods:
- Review of current literature on aortic stenosis diagnosis and imaging.
- Discussion of limitations of transthoracic echocardiography (TTE).
- Emphasis on complementary roles of transesophageal echocardiography (TEE), multidetector computed tomography (MDCT), and cardiac magnetic resonance (CMR).
Main Results:
- TTE can be limited by acoustic windows or specific patient conditions.
- Low-flow, low-gradient severe AS presents diagnostic dilemmas.
- Multimodality imaging aids in overcoming TTE limitations and clarifies AS severity.
Conclusions:
- Accurate diagnosis of AS, particularly in complex cases, requires a strategic use of various imaging techniques.
- A comprehensive multimodality cardiac imaging approach ensures precise disease grading.
- Precise AS grading is critical for guiding optimal therapeutic strategies.
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