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Question:

How seriously must one take mild sclerotic aortic valve changes?

56 year old male. Had a Doppler echocardiogram done which showed mild sclerotic aortic valve changes without diminished excursion. (the commissure of the left coronary leaflet). Take 50mg Atenolol -  blood pressure under control and 40mg Lipitor - cholesterol under control. Normal weight, exercise, watch diet. Is this something serious or just needs to be watched? Doctor didn't seemed that concerned. 

submitted by Alan from Tampa, Florida 9/1/2012

Answer:

Raymond F. Stainback, MDby Texas Heart Institute cardiologist, Raymond F. Stainback, MD    

"Sclerosis" of the aortic valve is commonly encountered on an echocardiogram in patients over age 50. If the valve leaflet excursion is normal (which appears to be the case), then there is nothing much to be concerned about. Some patients with aortic valve sclerosis (which is mild thickening and mild calcification of the leaflets) can progress to aortic valve stenosis (severe thickening and calcification with decreased mobility of the leaflets and actual partial obstruction to blood flow). Treatment of hypertension and abnormal lipids likely delays development of aortic stenosis (were this to be an issue). It sounds like things are in order and a follow up echocardiogram in a couple of years may be indicated. Progression from aortic sclerosis with no stenosis to significant aortic valve stenosis: This would take many years or even a decade or two to develop in the absence of renal failure. 

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Updated September 2012
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