Snapshot A 74-year-old man reports a 3-month history of intermittent chest pain, syncopal episodes, and dyspnea on exertion. He has a long-standing history of coronary artery disease and hypertension. Physical exam reveals a systolic crescendo-decrescendo murmur, heard best at the heart base and radiates to the carotids. He is sent for further evaluation with an echocardiogram. Introduction Clinical definition login to view 1 more bullet Associated conditions login to view 1 more bullet Etiology Age-related dystrophic calcification of normal (tricuspid) aortic valve in older patients Calcification of bicuspid aortic valve in younger patients Pathogenesis login to view 4 more bullets Epidemiology Demographics login to view 4 more bullets Risk factors login to view 3 more bullets Presentation Symptoms login to view 5 more bullets Physical exam login to view 15 more bullets Imaging Radiography login to view 6 more bullets Echocardiography login to view 10 more bullets Studies Electrocardiogram (ECG) login to view 4 more bullets Left heart catheterization login to view 6 more bullets Differential Hypertrophic cardiomyopathy login to view 2 more bullets Diagnosis Making the diagnosis login to view 1 more bullet Treatment Medical login to view 3 more bullets Operative login to view 12 more bullets Complications Arrhythmia Heart failure Endocarditis Prognosis Often asymptomatic Once symptomatic, most patients require aortic valve replacement