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Previous Volume 346:677-682 February 28, 2002 Number 9 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 60-year-old man is evaluated for a heart murmur. He jogs 3 mi (5 km) per day and is asymptomatic. Physical examination reveals a delayed carotid upstroke, a 3/6 late-peaking systolic ejection murmur that radiates to the neck, and a single S₂. An echocardiogram shows normal systolic function and a heavily calcified aortic valve. The patient's peak Doppler transvalvular gradient is . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Areas of Uncertainty

Management of Severe Asymptomatic Aortic Stenosis

Treatment of the Patient with a Low Gradient and Reduced Ejection Fraction

Safety of Cardiac Surgery in Patients with Mild-to-Moderate Aortic Stenosis

Safety of Noncardiac Surgery in Patients with Severe Asymptomatic Aortic Stenosis

Ability to Slow or Halt Progression of the Valve Lesion

Guidelines

Conclusions and Recommendations

Source Information

From the Department of Medicine, Baylor College of Medicine, and the Veterans Affairs Medical Center, Houston.

Address reprint requests to Dr. Carabello at the Veterans Affairs Medical Center Medical Service (111), 2002 Holcombe Blvd., Houston, TX 77030, or at blaseanthony.carabello@med.va.gov.

References

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