Aortic Stenosis > Diagnosis

Echocardiography to Diagnose Aortic Stenosis

The diagnosis of aortic stenosis is made primarily by physical examination and echocardiography.

Echocardiography is one key tool for diagnosis

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Patients with aortic stenosis will require complex echocardiography testing to achieve a definitive diagnosis of aortic stenosis. These specialised examinations should be performed by expertly trained cardiac sonographers who are trained in specific parameters around the diagnosis of aortic stenosis.

The severity of aortic stenosis is determined by measuring the aortic valve area (AVA) and calculating the pressure gradient between the LV and the aorta on echocardiography. Aortic stenosis is described as mild, moderate or severe based on these measurements.

Mean Gradient (mmHg) Aortic Valve Area (cm2)
Mild 15-25 >1.5
Moderate 25-40 1.0-1.5
Severe >40 0.7-1.0
Critical N/A <0.7

The echocardiogram confirms the diagnosis and the severity of aortic stenosis. Two-dimensional echocardiography can demonstrate a thickened aortic valve, reduced leaflet mobility, and concentric left ventricular hypertrophy. Doppler can be used to quantify the severity of aortic stenosis by measuring the pressure gradient across the aortic valve and by calculating the aortic valve area (AVA). The velocity of blood flow across the aortic valve, as determined by continuous-wave doppler, is used to calculate the transaortic pressure gradient1.