Aortic Valve Stenosis - Management

Management

Treatment is generally not necessary in people without symptoms. In moderate cases, echocardiography is performed every 1–2 years to monitor the progression, possibly complemented with a cardiac stress test. In severe cases, echocardiography is performed every 3–6 months. In both moderate and mild cases, the patient should immediately make a revisit or be admitted for inpatient care if any new related symptoms appear.

Medical Management: The effect of statins on the progression of AS is still not clear. The latest trials doesnot show any benefit in established AS. Angiotensin-converting enzyme (ACE) and angiotensin II receptors have been found in stenotic aortic valves. This leads to the hypothesis that probably renin-angiotensin system may play a role in the progression of the disease. To date, there is no randomized trial looking at the effect of ACEi in AS. Innasimuthu et al. showed that patients on bisphosphonates have less progression of aortic stenosis and some regressed. This finding led to multiple trials which is ongoing. Subsequent research has failed to confirm the initial positive result.


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