Skip to Main Content




  • Aortic valve stenosis

  • Left ventricular outflow tract obstruction

  • Rheumatic aortic stenosis

  • Calcium aortic stenosis




  • 395.0 Rheumatic aortic stenosis

  • 396.0 Mitral valve stenosis and aortic valve stenosis

  • 746.3 Congenital stenosis of aortic valve




  • I06.0 Rheumatic aortic valve diseases

  • I35.0 Aortic (valve) stenosis

  • I35.2 Aortic (valve) stenosis with insufficiency

  • Q23.0 Congenital stenosis of aortic valve




  • 6D: Impaired aerobic capacity/endurance associated with cardiovascular pump dysfunction or failure1



An 80-year-old male becomes short of breath while playing with his grandchildren at a family picnic. The patient states that he is dizzy and has chest pain. Vitals are: Pulse: 98, Respirations: 22, Blood pressure: 142/86, and SpO2% of 96%. On physical examination, the patient has a slow rate of rise in the carotid pulse, a systolic ejection murmur at the right second intercostal space and a reduced intensity of the second heart sound. The EKG reveals left ventricular hypertrophy, but no ST-T wave changes and a chest X-ray shows a rounding of the left ventricular apex.




  • Aortic valve does not open fully2

  • Narrowing of the aortic valve causing left ventricular outflow tract obstruction2

  • Causes decreased blood flow from left ventricle into the ascending aorta

  • Decreases blood flow from heart to rest of the body and brain

  • Decreased flow can cause lightheadedness, fainting, chest pain

  • Three types2

    • Congenital

    • Rheumatic

    • Degenerative

Essentials of Diagnosis

  • Stethoscope auscultation for ejection murmur at right second intercostal space

  • EKG/ECG3

  • Echocardiogram

  • Cardiac catheterization

  • Chest X-ray

  • Exercise stress test

General Considerations

  • Education on disease management reduces hospitalization

  • Patients with significant aortic stenosis (AS) should not participate in competitive sports, even without symptoms

  • Strenuous activity should be limited for symptomatic AS

  • Signs and symptoms should be monitored

  • Emphasis on wellness and prevention

  • Can lead to sudden cardiac death, arrhythmias, increased risk of bleeding, embolic events, coronary disease

  • Children can develop bacterial endocarditis

  • Can cause syncope, chest pain, heart failure if untreated


  • Can be congenital, present from birth

  • More commonly develops later in life as a result of calcification of the valve or previous rheumatic fever

  • More common in men than women





  • Symptoms depend on the degree of valve stenosis

  • Patient may have no symptoms until stenosis progresses

  • Audible systolic ejection murmur at right second intercostal space

  • Angina pectoris2

  • Syncope2

  • Congestive heart failure2

  • Dyspnea on exertion

  • Shortness of breath2

  • Anginal chest pain that increases with exercise

  • Orthopnea2

  • Fatigue, weakness2

  • Fainting, dizziness with activity

  • Palpitations

  • Palpable heaves/thrills over precordium

  • Pulsus parvus et tardus:...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.