Severe aortic stenosis: points of interest for the Internist concerning therapeutic orientation
Keywords:
Aortic stenosis, ultrasound criteria, severe, mild, symptomatic, degenerative disease, inflammatory processAbstract
Aortic stenosis is the most common valvular disease of the occidental world and the one which most frequently needs surgical
intervention. There is a higher prevalence with increasing age,
affecting 2 to 7% of the elderly. If mild to moderate, it is well
tolerated and usually asymptomatic. When severe, it is associated
with high morbidity and mortality.
Conventionally, aortic stenosis is considered a degenerative
process, in which damage to the valve has occurred due to time
and usage. However, only few elderly patients have aortic stenosis, even in bicuspid valves. Beyond the degenerative process
which develops with age, other factors seem to be involved in the development of the disease.
Risk-benefit analysis favours an early surgical intervention,
bearing in mind the excellent surgical technique involved and
consequent low risk associated with valvular substitution.
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