How do you work-up the patient with aortic stenosis?

To Determine Diagnosis
  • Focused history and clinical examination
  • Transthoracic echocardiography
To Determine Severity / Prognosis
  • Transthoracic echocardiography
  • Additional tests depending upon clinical features
    • Exercise testing (in asymptomatic patients)
    • CT calcium scoring
    • Exercise stress echo
    • Dobutamine stress echo
    • Cardiac catheterization and determination of transvalvular gradient (also give information about any concurrent coronary artery disease)
To Assess for Complications
  • ECG: LVH, LV strain
  • CXR: cardiomegaly, signs of LV failure
  • FBC: haemolytic anaemia