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What are the investigation findings in aortic stenosis?

Important investigations in aortic stenosis are
  • ECG
  • CXR
  • Echo
  • Cardiac catheterisation
ECG findings in AS
  • Left ventricular hypertrophy with or without strain may be present (LVH + strain). But absence  of LVH does not rule out the presence of critical AS. There is no correlation between LVH voltage criteria and severity of AS.AS severity correlate with total QRS voltage.
  • Pseudo infarction pattern can be seen, which is seen as loss of r wave in precordial leads
  • Left atrial overload can occur.
  • AV block or left anterior hemiblock.
  • Ventricular arrhythmia and  complete heard block if calcification of valve extend into conducting system.
Chest X-ray findings in AS
  • Normal sized heart with post stenotic diltation can occur. If there is cardiomegaly look for cardiac failure or aortic regurgitation.
  • Left atrial enlargement (LAE) – indicate co-existing mitral stenosis (MS).
  • Calcification of aortic valve may be seen.
Echocardiographic findings in AS
  • Stenotic valve
  • Left ventricular hypertrophy
  • Pressure gradient assessment