An 82-year-old previously healthy male presented with exertional dyspnea and lower extremity edema. Physical examination reveals a IV/VI systolic murmur at the right upper sternal border peaking late in systole with no audible S2 heart sound. The murmur radiates to the cardiac apex where it sounds holosystolic, however, does not increase with handgrip maneuvers. The carotid upstroke is weak and delayed.
Echocardiography suggests the presence of aortic valve stenosis with a mean pressure gradient of 45 mmHg and an aortic valve area of 0.8 cm2. How to confirm the diagnosis and severity? What is the likely etiology? *This case is from Docplexus Editorial Team for educative purpose only.
