Medical treatment of aortic stenosis: promising, or wishful thinking?

نویسنده

Alan S Pearlman

چکیده

Valvular aortic stenosis (AS) is a prevalent condition and one of the most common indications for valve replacement surgery. Although AS can be congenital in etiology or a consequence of rheumatic fever, the most common form is “calcific” AS. Calcific AS is usually seen in patients over the age of 65 years, and as the population continues to grow older, the number of patients with AS is almost certain to rise. Using both noninvasive and invasive techniques, a number of studies have documented that AS is a progressive disease, although the rate of progression may vary considerably from patient to patient. At present, no medical therapy has been proved effective in patients with severe AS. The management of patients with AS has been reviewed in a recent update (1). When AS causes symptoms of heart failure, syncope, or angina, prompt surgical replacement of the stenotic aortic valve is indicated. Although asymptomatic patients with AS have a relatively good prognosis, a subgroup of patients who lack symptoms at rest will demonstrate poor exercise tolerance or other worrisome

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