2365:
Endocarditis, and
Kawasaki Disease Committee; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Surgery and Anesthesia; Quality of Care and Outcomes Research Interdisciplinary Working Group. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007 Oct 9;116(15):1736-54. doi: 10.1161/CIRCULATIONAHA.106.183095. Epub 2007 Apr 19. Erratum in: Circulation. 2007 Oct 9;116(15):e376-7. PMID 17446442.
50:
789:
736:
797:
1353:(AVR). While Surgical AVR has remained the most effective treatment for this disease process and is currently recommended for patients after the onset of symptoms, as of 2016 aortic valve replacement approaches included open-heart surgery, minimally invasive cardiac surgery (MICS), and minimally invasive catheter-based (percutaneous) aortic valve replacement. However, surgical aortic valve replacement is well-studied, and generally has a good and well-established longer-term prognosis.
772:, a highly damaging substance, into the aortic valve, causing significant damage and stenosis over time. Infiltration of inflammatory cells (macrophages, T lymphocytes), followed by the release of inflammatory mediators such as interleukin-1-beta and transforming growth factor beta-1 occurs. Subsequently, fibroblasts differentiate into osteoblast-like cells, which results in abnormal bone matrix deposition leading to progressive valvular calcification and stenosis.
677:
1381:, where a balloon is inflated to stretch the valve and allow greater flow, may also be effective. In adults, however, it is generally ineffective, as the valve tends to return to a stenosed state. The surgeon will make a small incision at the top of the person's leg and proceed to insert the balloon into the artery. The balloon is then advanced up to the valve and is inflated to stretch the valve open.
4213:
902:). Hence, the physical exam in aortic stenosis may also reveal signs of the latter, for example, an early diastolic decrescendo murmur. Indeed, when both valve abnormalities are present, the expected findings of either may be modified or may not even be present. Rather, new signs that reflect the presence of simultaneous aortic stenosis and insufficiency, e.g.,
1369:(TAVI). For people who are not candidates for surgical valve replacement and most patients who are older than 75, TAVI may be a suitable alternative. Conduction abnormalities requiring permanent pacemaker (PPM) implantation remain a common finding after TAVI due to the close proximity of the atrioventricular conduction system to the aortic root.
398:. It affects about 2% of people who are over 65 years of age. Estimated rates were not known in most of the developing world as of 2014. In those who have symptoms, without repair the chance of death at five years is about 50% and at 10 years is about 90%. Aortic stenosis was first described by French physician Lazare Rivière in 1663.
1065:
before surgery. The standard for diagnosis of aortic stenosis is non-invasive testing with echocardiography. Cardiac catheterization is reserved for cases in which there is a discrepancy between the clinical picture and non-invasive testing, due to risks inherent to crossing the aortic valve, such as stroke.
814:
and can sometimes be detected during routine examination of the heart and circulatory system. Good evidence exists to demonstrate that certain characteristics of the peripheral pulse can rule in the diagnosis. In particular, there may be a slow and/or sustained upstroke of the arterial pulse, and the
700:
or, more rarely, a congenital unicuspid aortic valve. Those with unicuspid aortic valves typically need intervention when very young, often as a newborn. While those with congenital bicuspid aortic valve make up 30-40% of those presenting during adulthood and typically presenting earlier (ages 40+ to
514:
dilate to allow the muscles to receive more blood to allow them to do more work. This decrease in peripheral vascular resistance is normally compensated for by an increase in the cardiac output. Since people with severe AS cannot increase their cardiac output, the blood pressure falls and the person
1412:
If untreated, severe symptomatic aortic stenosis carries a poor prognosis, with a 2-year mortality rate of 50-60% and a 3-year survival rate of less than 30%. Prognosis after aortic valve replacement for people younger than 65 is about five years less than that of the general population; for people
1334:
Aortic valve repair or aortic valve reconstruction describes the reconstruction of both form and function of the native and dysfunctioning aortic valve. Most frequently it is applied for the treatment of aortic regurgitation. It can also become necessary for the treatment of an aortic aneurysm, less
1209:
The use of CT calcium scoring is gaining spread as a diagnostic tool to complement echo in the assessment of patients with aortic stenosis. Aortic valve calcium scoring by multidetector computed tomography (CT-AVC) is used to quantify the degree of calcification of the aortic valve. According to the
779:
In the later stages, the left ventricle dilates, the wall thins, and the systolic function deteriorates (resulting in impaired ability to pump blood forward). Morris and
Innasimuthu et al. showed that different coronary anatomy is associated with different valve diseases. Research was in progress in
751:
normally consists of three cusps or leaflets and has an opening of 3.0-4.0 square centimeters. When the left ventricle contracts, it forces blood through the valve into the aorta and subsequently to the rest of the body. When the left ventricle expands again, the aortic valve closes and prevents the
409:
related to aortic stenosis depend on the degree of stenosis. Most people with mild to moderate aortic stenosis do not have symptoms. Symptoms usually present in individuals with severe aortic stenosis, though they may also occur in those with mild to moderate aortic stenosis. The three main symptoms
2364:
Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, Bolger A, Cabell CH, Takahashi M, Baltimore RS, Newburger JW, Strom BL, Tani LY, Gerber M, Bonow RO, Pallasch T, Shulman ST, Rowley AH, Burns JC, Ferrieri P, Gardner T, Goff D, Durack DT; American Heart
Association Rheumatic Fever,
1230:
care if any new related symptoms appear. There are no therapeutic options currently available to treat people with aortic valve stenosis; however, studies in 2014 indicated that the disease occurs as a result of active cellular processes, suggesting that targeting these processes may lead to viable
845:
and the apex, and, thus, appear to be "split". The ejection sound, caused by the impact of left ventricular outflow against the partially fused aortic valve leaflets, is more commonly associated with a mobile bicuspid aortic valve than an immobile calcified aortic valve. The intensity of this sound
664:. Under normal circumstances, in the absence of aortic stenosis, the heart is able to increase its output and thereby offset the effect of the dilated blood vessels. In some cases of aortic stenosis, however, due to the obstruction of blood flow out of the heart caused by the stenosed aortic valve,
469:
may first be evident during exercise when the heart muscle requires increased blood supply to compensate for the increased workload. The individual may complain of anginal chest pain with exertion. Exercise stress testing with or without imaging is strictly contraindicated in symptomatic patients
800:
Simultaneous left ventricular and aortic pressure tracings to demonstrate a pressure gradient between the left ventricle and aorta, suggesting aortic stenosis. The left ventricle generates higher pressures than what is transmitted to the aorta. The pressure gradient, caused by aortic stenosis, is
775:
As a consequence of this stenosis, the left ventricle must generate a higher pressure with each contraction to effectively move blood forward into the aorta. Initially, the LV generates this increased pressure by thickening its muscular walls (myocardial hypertrophy). The type of hypertrophy most
1356:
A diseased aortic valve is most commonly replaced using a surgical procedure with either a mechanical or a tissue valve. The procedure is done either in an open-heart surgical procedure or, in a smaller but growing number of cases, a minimally invasive cardiac surgery (MICS) procedure. Minimally
1064:
provides a definitive diagnosis, indicating severe stenosis in valve area of <1.0 cm (normally about 3 cm). It can directly measure the pressure on both sides of the aortic valve. The pressure gradient may be used as a decision point for treatment. It is useful in symptomatic people
3302:
Vahanian, Alec; Beyersdorf, Friedhelm; Praz, Fabien; Milojevic, Milan; Baldus, Stephan; Bauersachs, Johann; Capodanno, Davide; Conradi, Lenard; De Bonis, Michele; De Paulis, Ruggero; Delgado, Victoria; Freemantle, Nick; Gilard, Martine; Haugaa, Kristina H; Jeppsson, Anders (2022-02-12).
2766:
Vahanian, Alec; Beyersdorf, Friedhelm; Praz, Fabien; Milojevic, Milan; Baldus, Stephan; Bauersachs, Johann; Capodanno, Davide; Conradi, Lenard; De Bonis, Michele; De Paulis, Ruggero; Delgado, Victoria; Freemantle, Nick; Gilard, Martine; Haugaa, Kristina H; Jeppsson, Anders (2022-02-12).
1169:
A normal aortic valve has a gradient of only a few mmHg. A decreased valvular area causes increased pressure gradient, and these parameters are used to classify and grade the aortic stenosis as mild, moderate or severe. The pressure gradient can be abnormally low in the presence of
639:
Since the stenosed aortic valve may limit the heart's output, people with aortic stenosis are at risk of syncope and dangerously low blood pressure should they use any of a number of medications for cardiovascular diseases that often coexist with aortic stenosis. Examples include
526:
that, in turn, causes decreased blood flow to the brain resulting in loss of consciousness. Indeed, in aortic stenosis, because of the fixed obstruction to blood flow out from the heart, it may be impossible for the heart to increase its output to offset peripheral vasodilation.
2426:
Zalaquett S, Ricardo; Camplá C, Cristóbal; Scheu G, Maximiliano; Córdova A, Samuel; Becker R, Pedro; Morán V, Sergio; Irarrázaval Ll, Manuel J; Baeza P, Cristian; Arretz V, Claudio; Braun J, Sandra; Chamorro S, Gastón; Godoy J, Iván; Yáñez D, Fernando (March 2005).
2853:
Clavel, Marie-Annick; Malouf, Joseph; Michelena, Hector I.; Suri, Rakesh M.; Jaffe, Allan S.; Mahoney, Douglas W.; Enriquez-Sarano, Maurice (2014-05-20). "B-Type
Natriuretic Peptide Clinical Activation in Aortic Stenosis: Impact on Long-Term Survival".
363:(BAV), may result in benefit, but for only a few months. Complications such as heart failure may be treated in the same way as in those with mild to moderate AS. In those with severe disease a number of medications should be avoided, including
5764:
5741:
883:) tends to become decreased and softer as the aortic stenosis becomes more severe. This is a result of the increasing calcification of the valve preventing it from "snapping" shut and producing a sharp, loud sound. Due to increases in
636:. Specifically, as of 2007 it is recommended that such prophylaxis should be limited only to those with prosthetic heart valves, those with previous episode(s) of endocarditis, and those with certain types of congenital heart disease.
499:(fainting spells) from aortic valve stenosis is usually exertional. In the setting of heart failure it increases the risk of death. In people with syncope, the three-year mortality rate is 50% if the aortic valve is not replaced.
2907:
Hadziselimovic, Edina; Greve, Anders M.; Sajadieh, Ahmad; Olsen, Michael H.; Kesäniemi, Y. Antero; Nienaber, Christoph A.; Ray, Simon G.; Rossebø, Anne B.; Willenheimer, Ronnie; Wachtell, Kristian; Nielsen, Olav W. (2022-04-01).
1357:
invasive approach via right minithoracotomy is most beneficial in the high risk patient such as the elderly, the obese, those with chronic obstructive pulmonary, chronic kidney disease and those requiring re-operative surgery.
3474:
Nielsen, Olav W.; Sajadieh, Ahmad; Sabbah, Muhammad; Greve, Anders M.; Olsen, Michael H.; Boman, Kurt; Nienaber, Christoph A.; Kesäniemi, Y. Antero; Pedersen, Terje R.; Willenheimer, Ronnie; Wachtell, Kristian (2016-08-09).
1421:
Approximately 2% of people over the age of 65, 3% of people over age 75, and 4% percent of people over age 85 have aortic valve stenosis. The prevalence is increasing with the aging population in North
America and Europe.
2752:
Silverman ME. The Third Heart Sound. In: Walker HK, Hall WD, Hurst JW, editors. Clinical
Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 24. Available from:
1465:
were found in a 2010 study to have less progression of aortic stenosis, and some regressed. This finding led to multiple trials, ongoing as of 2012. Subsequent research failed to confirm the initial positive result.
3185:
Beyersdorf, Friedhelm; Vahanian, Alec; Milojevic, Milan; Praz, Fabien; Baldus, Stephan; Bauersachs, Johann; Capodanno, Davide; Conradi, Lenard; De Bonis, Michele; De Paulis, Ruggero; Delgado, Victoria (2021-10-22).
3127:
Otto, Catherine M.; Nishimura, Rick A.; Bonow, Robert O.; Carabello, Blase A.; Erwin, John P.; Gentile, Federico; Jneid, Hani; Krieger, Eric V.; Mack, Michael; McLeod, Christopher; O'Gara, Patrick T. (2021-02-02).
3116:
Zoghbi WA. Low-gradient "severe" aortic stenosis with normal systolic function: time to refine the guidelines? Circulation. 2011 Mar 1;123(8):838-40. doi: 10.1161/CIRCULATIONAHA.110.015826. Epub 2011 Feb 14. PMID
1153:
non-invasively using echocardiographic flow velocities. Using the velocity of the blood through the valve, the pressure gradient across the valve can be calculated by the continuity equation or using the modified
2739:
Alpert MA. Systolic
Murmurs. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 26. Available from:
568:(CHF) carries a grave prognosis in people with AS. People with CHF attributable to AS have a 2-year mortality rate of 50% if the aortic valve is not replaced. CHF in the setting of AS is due to a combination of
2551:
Mohler ER 3rd, Gannon F, Reynolds C, Zimmerman R, Keane MG, Kaplan FS. Bone formation and inflammation in cardiac valves. Circulation. 2001 Mar 20;103(11):1522-8. doi: 10.1161/01.cir.103.11.1522. PMID 11257079.
3634:
Thourani, VH; Suri, RM; Gunter, RL; Sheng, S; O'Brien, SM; Ailawadi, G; Szeto, WY; Dewey, TM; Guyton, RA; Bavaria, JE; Babaliaros, V; Gammie, JS; Svensson, L; Williams, M; Badhwar, V; Mack, MJ (January 2015).
2965:
Hadziselimovic, Edina; Greve, Anders M.; Sajadieh, Ahmad; Olsen, Michael H.; Kesäniemi, Y. Antero; Nienaber, Christoph A.; Ray, Simon G.; Rossebø, Anne B.; Wachtell, Kristian; Nielsen, Olav W. (April 2023).
3130:"2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines"
873:(HOCM). The murmur is louder during expiration but is also easily heard during inspiration. The more severe the degree of the stenosis, the later the peak occurs in the crescendo-decrescendo of the murmur.
917:
ranged 2.8–130 across studies), mid to late peak intensity of the murmur (positive likelihood ratio, 8.0–101), and decreased intensity of the second heart sound (positive likelihood ratio, 3.1–50).
465:
of the left ventricle thickens, the arteries that supply the muscle do not get significantly longer or bigger, so the muscle may not receive enough blood supply to meet its oxygen requirement. This
2910:"Association of Annual N-Terminal Pro-Brain Natriuretic Peptide Measurements With Clinical Events in Patients With Asymptomatic Nonsevere Aortic Stenosis: A Post Hoc Substudy of the SEAS Trial"
1997:
Algranati D, Kassab GS, Lanir Y. Why is the subendocardium more vulnerable to ischemia? A new paradigm. Am J Physiol Heart Circ
Physiol. 2011;300(3):H1090-H1100. doi:10.1152/ajpheart.00473.2010
764:
from increased mechanical stress. Inflammation is thought to be involved in the earlier stages of the pathogenesis of AS and its associated risk factors are known to promote the deposition of
4159:
1257:
In general, medical therapy has relatively poor efficacy in treating aortic stenosis. However, it may be useful to manage commonly coexisting conditions that correlate with aortic stenosis:
2814:
Bergler-Klein, Jutta; Klaar, Ursula; Heger, Maria; Rosenhek, Raphael; Mundigler, Gerald; Gabriel, Harald; Binder, Thomas; Pacher, Richard; Maurer, Gerald; Baumgartner, Helmut (2004-05-18).
1988:
Magne J, Lancellotti P, Piérard LA. Exercise testing in asymptomatic severe aortic stenosis. JACC Cardiovasc
Imaging. 2014 Feb;7(2):188-99. doi: 10.1016/j.jcmg.2013.08.011. PMID 24524744.
3449:
Marquis-Gravel G, Redfors B, Leon MB, Généreux P. Medical
Treatment of Aortic Stenosis. Circulation. 2016 Nov 29;134(22):1766-1784. doi: 10.1161/CIRCULATIONAHA.116.023997. PMID 27895025.
833:
artery ('apical-carotid delay'). In a similar manner, there may be a delay between the appearance of each pulse in the brachial artery (in the arm) and the radial artery (in the wrist).
1250:
published in 2005 failed to find any effect on calcific aortic stenosis. The effect of statins on the progression of AS is unclear. A 2007 study found a slowing of aortic stenosis with
846:
does not vary with respiration, which helps distinguish it from the ejection click produced by a stenotic pulmonary valve, which will diminish slightly in intensity during inspiration.
2145:
Richards AM, Nicholls MG, Ikram H, Hamilton EJ, Richards RD. Syncope in aortic valvular stenosis. Lancet. 1984 Nov 17;2(8412):1113-6. doi: 10.1016/s0140-6736(84)91555-1. PMID 6150181.
1210:
2021 ESC/EACTS Guidelines for the management of valvular heart disease the recommended thresholds indicating severe aortic stenosis are > 1200 AU in women and > 2000 AU in men.
1185:
Echocardiogram may also show left ventricular hypertrophy, thickened and immobile aortic valve, and dilated aortic root. However, it may appear deceptively normal in acute cases.
488:, suggesting subendocardial ischemia. The subendocardium is the region that is most susceptible to ischemia because it is the most distant from the epicardial coronary arteries.
4928:
3022:
Vranic II. Electrocardiographic appearance of aortic stenosis before and after aortic valve replacement. Ann Noninvasive Electrocardiol. 2017;22(5):e12457. doi:10.1111/anec.12457
3591:"Transcatheter or surgical aortic valve replacement for patients with severe, symptomatic, aortic stenosis at low to intermediate surgical risk: a clinical practice guideline"
3589:
Vandvik PO, Otto CM, Siemieniuk RA, Bagur R, Guyatt GH, Lytvyn L, Whitlock R, Vartdal T, Brieger D, Aertgeerts B, Price S, Foroutan F, Shapiro M, Mertz R, Spencer FA (2016).
2484:
VOC=VITIUM ORGANICUM CORDIS, a compendium of the Department of Cardiology at Uppsala Academic Hospital. By Per Kvidal September 1999, with revision by Erik Björklund May 2008
522:
A second theory is that during exercise the high pressures generated in the hypertrophied left ventricle cause a vasodepressor response, which causes a secondary peripheral
5354:
3779:"Minimally invasive aortic valve replacement with sutureless bioprosthesis through right minithoracotomy with completely central cannulation-Early results in 203 patients"
971:
261:
as well as above and below this level. It typically gets worse over time. Symptoms often come on gradually with a decreased ability to exercise often occurring first. If
743:
of cardiovascular calcification, showing in orange calcium phosphate spherical particles (denser material) and, in green, the extracellular matrix (less dense material).
3681:"Prognosis after surgical replacement with a bioprosthetic aortic valve in patients with severe symptomatic aortic stenosis: systematic review of observational studies"
978:) levels alone and combined with a 50% or greater increase from baseline had been found associated with increased event rates of aortic valve stenosis related events (
4174:
Bonow, Robert O.; Brown, Alan S.; Gillam, Linda D.; Kapadia, Samir R.; Kavinsky, Clifford J.; Lindman, Brian R.; Mack, Michael J.; Thourani, Vinod H. (October 2017).
3103:
1226:. In severe cases, echocardiography is performed every 3–6 months. In both moderate and mild cases, the person should immediately make a revisit or be admitted for
3539:"Transcatheter versus surgical aortic valve replacement in patients with severe aortic stenosis at low and intermediate risk: systematic review and meta-analysis"
470:
with severe aortic stenosis. Exercise stress test is now recommended by current guidelines in asymptomatic patients and may provide incremental prognostic value.
454:
Angina in setting of heart failure also increases the risk of death. In people with angina, the 5-year mortality rate is 50% if the aortic valve is not replaced.
891:
due to the stiff ventricle. With continued increases in ventricular pressure, dilatation of the ventricle will occur, and a third heart sound may be manifest.
332:, and being male. The aortic valve usually has three leaflets and is located between the left ventricle of the heart, and the aorta. AS typically results in a
5707:
3054:
Płońska-Gościniak, E; Lichodziejewska, B; Szyszka, A; Kukulski, T; Kasprzak, J; Dzikowska-Diduch, O; Gackowski, A; Gościniak, P; Pysz, P; Gąsior1, Z (2019).
1254:. In 2013 it was reported that trials did not show any benefit in slowing AS progression, but did demonstrate a decrease in ischemic cardiovascular events.
5405:
4569:
3032:
3826:
Sammour, Y; Krishnaswamy, A; Kumar, A; Puri, R; Tarakji, KG; Bazarbashi, N; Harb, S; Griffin, B; Svensson, L; Wazni, O; Kapadia, SR (25 January 2021).
1042:
550:
5410:
4259:
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4164:
914:
870:
3477:"Assessing Optimal Blood Pressure in Patients With Asymptomatic Aortic Valve Stenosis: The Simvastatin Ezetimibe in Aortic Stenosis Study (SEAS)"
1197:
can also assist in the diagnosis and provide clues as to the severity of the disease, showing the degree of calcification of the valve, and in a
5347:
4303:
348:
3521:
2724:
2572:
2046:
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461:(LVH) that is caused by the constant production of increased pressure required to overcome the pressure gradient caused by the AS. While the
2968:"Association of high-sensitivity troponin T with outcomes in asymptomatic non-severe aortic stenosis: a post-hoc substudy of the SEAS trial"
4981:
4790:
4627:
4176:"ACC/AATS/AHA/ASE/EACTS/HVS/SCA/SCAI/SCCT/SCMR/STS 2017 Appropriate Use Criteria for the Treatment of Patients With Severe Aortic Stenosis"
273:
occur due to AS the outcomes are worse. Loss of consciousness typically occurs with standing or exercising. Signs of heart failure include
887:
from the stenotic aortic valve, over time the ventricle may hypertrophy, resulting in diastolic dysfunction. As a result, there may be a
4795:
4785:
4374:
3910:
780:
2010 to see if different coronary anatomy might lead to turbulent flow at the level of valves leading to inflammation and degeneration.
913:, the most useful findings for ruling in aortic stenosis in the clinical setting were slow rate of rise of the carotid pulse (positive
549:
Finally, in calcific aortic stenosis at least, the calcification in and around the aortic valve can progress and extend to involve the
5483:
5442:
5400:
5092:
4923:
4537:
3637:"Contemporary real-world outcomes of surgical aortic valve replacement in 141,905 low-risk, intermediate-risk, and high-risk patients"
1007:
308:. A bicuspid aortic valve affects about one to two percent of the population. As of 2014 rheumatic heart disease mostly occurs in the
1041:
As noted above, the calcification process that occurs in aortic stenosis can progress to extend beyond the aortic valve and into the
5340:
4963:
3904:
1389:
49:
2103:
Richards, Mark; Ikram, Hamid; Nicholls, M. Gary; Hamilton, Eric; Richards, Rosemary (1984). "Syncope in aortic valvular stenosis".
2621:
Morris GM, Innasimuthu AL, Fox JP, Perry RA (May 2010). "The association of heart valve diseases with coronary artery dominance".
788:
5660:
4958:
1034:(LVH) are common in aortic stenosis and arise as a result of the stenosis having placed a chronically high-pressure load on the
5871:
5665:
5555:
4827:
4608:
1061:
760:) (e.g., due to calcification). Degenerative (the most common variety), and bicuspid aortic stenosis both begin with damage to
343:
Aortic stenosis is typically followed using repeated ultrasound scans. Once it has become severe, treatment primarily involves
3875:
5876:
5475:
4903:
4898:
4822:
1011:
507:
4622:
865:
bilaterally. The murmur increases with squatting and decreases with standing and isometric muscular contraction such as the
776:
commonly seen in AS is known as concentric hypertrophy, in which the walls of the LV are (approximately) equally thickened.
3620:
5550:
5417:
5388:
5249:
5125:
5054:
4886:
1150:
3828:"Incidence, Predictors, and Implications of Permanent Pacemaker Requirement After Transcatheter Aortic Valve Replacement"
5380:
5244:
5037:
5020:
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4252:
4015:
Innasimuthu AL, Katz WE (January 2011). "Effect of bisphosphonates on the progression of degenerative aortic stenosis".
1031:
959:
955:
712:
696:
causes hardening and stenosis of the valve. Another major cause of aortic stenosis is the calcification of a congenital
569:
458:
427:
360:
282:
201:
5087:
1601:
Bertazzo, Sergio; Gentleman, Eileen; Cloyd, Kristy L.; Chester, Adrian H.; Yacoub, Magdi H.; Stevens, Molly M. (2013).
796:
735:
4532:
384:
5069:
4557:
4542:
629:
5393:
4844:
4109:
Aksoy O, Cam A, Goel SS, et al. (April 2012). "Do bisphosphonates slow the progression of aortic stenosis?".
5457:
5447:
5147:
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4739:
4466:
2169:"Nano-analytical electron microscopy reveals fundamental insights into human cardiovascular tissue calcification"
1603:"Nano-analytical electron microscopy reveals fundamental insights into human cardiovascular tissue calcification"
1393:
1247:
1038:(with LVH being the expected response to chronic pressure loads on the left ventricle no matter what the cause).
884:
842:
593:
356:
344:
78:
5097:
756:) into the left ventricle. In aortic stenosis, the opening of the aortic valve becomes narrowed or constricted (
5787:
5577:
5545:
5271:
5027:
4817:
4714:
4695:
4525:
4298:
1442:
1350:
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1301:
1050:
987:
967:
565:
197:
31:
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and also ischaemic heart disease (disease related to the decreased blood supply and oxygen causing ischemia).
5702:
5572:
5363:
5304:
5278:
5266:
5254:
5239:
4973:
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991:
817:
313:
123:
62:
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represented by the green shaded area. (AO = ascending aorta; LV = left ventricle; ECG = electrocardiogram.)
5525:
5504:
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Eventually, however, the heart muscle will require more blood supply at rest than can be supplied by the
5712:
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5605:
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4652:
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4357:
3097:
2816:"Natriuretic Peptides Predict Symptom-Free Survival and Postoperative Outcome in Severe Aortic Stenosis"
1378:
1239:
1003:
716:
704:
697:
617:
577:
443:
297:
146:
74:
1222:
echocardiography is performed every 1–2 years to monitor the progression, possibly complemented with a
502:
It is unclear why aortic stenosis causes syncope. One theory is that severe AS produces a nearly fixed
2909:
5632:
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5582:
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5434:
5153:
4681:
4662:
4562:
4473:
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1030:(ECG), it still often leads to a number of electrocardiographic abnormalities. ECG manifestations of
929:
899:
895:
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The first heart sound may be followed by a sharp ejection sound ("ejection click") best heard at the
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2308:
Horiuchi, Hisanori; Doman, Tsuyoshi; Kokame, Koichi; Saiki, Yoshikatsu; Matsumoto, Masanori (2019).
5768:
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5015:
5010:
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4837:
4807:
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4392:
4309:
3926:"Pathophysiology of aortic stenosis and approach to treatment with percutaneous valve implantation"
2674:
Etchells E, Bell C, Robb K (February 1997). "Does this patient have an abnormal systolic murmur?".
1329:
1223:
1146:(heart ultrasound) is the best non-invasive way to evaluate the aortic valve anatomy and function.
740:
589:
274:
108:
3245:
Pawade, Tania; Sheth, Tej; Guzzetti, Ezequiel; Dweck, Marc R.; Clavel, Marie-Annick (2019-09-01).
970:. In patients with non-severe asymptomatic aortic valve stenosis, increased age- and sex adjusted
5261:
5059:
4881:
4832:
4457:
4404:
4314:
4040:
3857:
3808:
3284:
3167:
2534:
2128:
1756:
1438:
1198:
1045:. Evidence of this phenomenon may rarely include ECG patterns characteristic of certain types of
888:
877:
858:
850:
707:
post-inflammatory is the cause of less than 10% of cases. Rare causes of aortic stenosis include
496:
419:
411:
266:
213:
104:
98:
2716:
2712:
Pathophysiology of heart disease : a collaborative project of medical students and faculty
2710:
1284:
is treated aggressively, but caution must be taken in administering beta-blockers. The optimal
336:. Its severity can be divided into mild, moderate, severe, and very severe, distinguishable by
5827:
5798:
5567:
5321:
5172:
5130:
5045:
4863:
4761:
4478:
4421:
4319:
4197:
4126:
4091:
4032:
3988:
3947:
3900:
3894:
3849:
3800:
3759:
3710:
3658:
3612:
3568:
3517:
3496:
3432:
3383:
3334:
3326:
3304:
3276:
3268:
3227:
3219:
3159:
3151:
3085:
3005:
2987:
2947:
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2889:
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2796:
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2768:
2720:
2691:
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2568:
2526:
2408:
2347:
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2249:
2206:
2120:
2085:
2042:
1946:
1905:
1845:
1791:
1748:
1692:
1648:
1630:
1583:
1434:
1425:
Risk factors known to influence disease progression of AS include factors similar to those of
1293:
1027:
999:
940:
903:
866:
822:
676:
573:
535:
435:
329:
182:
174:
86:
3967:"Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study"
2650:"Left Dominant Coronary arterial system and Aortic stenosis: an association, cause or effect"
1731:
Manning WJ (October 2013). "Asymptomatic aortic stenosis in the elderly: a clinical review".
1671:"Inotropes and vasopressors: review of physiology and clinical use in cardiovascular disease"
5697:
5692:
5294:
5186:
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4775:
4187:
4118:
4081:
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4024:
3978:
3937:
3839:
3790:
3749:
3741:
3700:
3692:
3648:
3602:
3558:
3550:
3488:
3459:
Rutherford SD, Braunwald E (1992). "Chronic ischaemic heart disease". In Braunwald E (ed.).
3422:
3414:
3403:"Rosuvastatin affecting aortic valve endothelium to slow the progression of aortic stenosis"
3373:
3365:
3316:
3258:
3209:
3199:
3141:
3075:
3067:
2995:
2979:
2937:
2921:
2871:
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2683:
2601:
2516:
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2398:
2388:
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2241:
2196:
2188:
2112:
2075:
1936:
1895:
1835:
1827:
1783:
1740:
1682:
1638:
1622:
1573:
1563:
761:
511:
325:
309:
286:
187:
170:
116:
3516:: Current treatment of aortic regurgitation. UNI-MED Science, Bremen, London, Boston 2013,
5687:
5627:
5562:
5540:
5316:
4708:
4689:
4483:
4362:
4154:
3187:
2031:
Chapter 1: Diseases of the Cardiovascular system > Section: Valvular Heart Disease in:
1774:
Thaden, JJ; Nkomo, VT; Enriquez-Sarano, M (2014). "The global burden of aortic stenosis".
1289:
1266:
1171:
963:
765:
601:
474:
415:
395:
317:
301:
162:
150:
91:
70:
3896:
Managing Acute Decompensated Heart Failure a Clinician's Guide to Diagnosis and Treatment
3876:"Aortic valve stenosis - Treatment - Surgery or Other procedures - Balloon valvuloplasty"
1831:
4218:
3745:
3000:
2967:
2715:(4th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. p.
2403:
2376:
2237:
2184:
1618:
5309:
5217:
5115:
5107:
5005:
4515:
4508:
4495:
4086:
4059:
3754:
3729:
3705:
3680:
3563:
3538:
3427:
3402:
3378:
3353:
3080:
3055:
2942:
2831:
2342:
2309:
2201:
2168:
2080:
2063:
2035:
1840:
1815:
1643:
1602:
1578:
1551:
1462:
1430:
1285:
1143:
1035:
933:
862:
769:
665:
597:
531:
503:
480:
462:
364:
351:(TAVR) being an option in some who are at high risk from surgery. Valves may either be
337:
246:
5781:
5777:
5773:
3983:
3966:
3492:
2116:
1941:
1924:
1687:
1670:
990:
surgery). In patients with non-severe asymptomatic aortic valve stenosis and no overt
5865:
5655:
5499:
5299:
5210:
4345:
4149:
4044:
4028:
3861:
3812:
3653:
3636:
3288:
3171:
2562:
1964:
1760:
1401:
1397:
1316:
1175:
983:
979:
910:
720:
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693:
689:
649:
641:
380:
376:
368:
305:
262:
128:
17:
3247:"Why and How to Measure Aortic Valve Calcification in Patients With Aortic Stenosis"
2445:
2428:
2285:
2268:
2132:
5677:
5622:
5600:
5231:
5205:
5049:
4997:
4670:
4646:
4616:
4593:
4462:
4452:
2590:"The association of heart valve diseases with a dominant left coronary circulation"
2538:
1281:
1262:
1251:
854:
826:
811:
748:
661:
633:
523:
372:
333:
321:
258:
166:
58:
5849:
5838:
2167:
Bertazzo S, Gentleman E, Cloyd KL, Chester AH, Yacoub MH, Stevens MM (June 2013).
2154:
Seger JJ. Syncope evaluation and management. Tex Heart Inst J. 2005;32(2):204-206.
1925:"A view from the millennium: the practice of cardiology circa 1950 and thereafter"
5792:
4237:
3146:
3129:
2983:
2925:
954:
For asymptomatic severe aortic valve stenosis, the European guidelines recommend
5822:
5670:
5166:
5064:
4854:
4771:
4753:
4579:
4552:
4503:
4444:
3590:
3321:
2784:
1453:
Aortic stenosis was first described by French physician Lazare Rivière in 1663.
1274:
1194:
1046:
657:
613:
609:
554:
543:
431:
157:
4192:
4175:
4122:
3844:
3827:
3418:
3263:
3246:
2867:
2606:
2589:
2393:
1787:
5844:
5758:
5754:
5750:
5682:
5194:
4744:
2649:
995:
539:
5803:
3942:
3925:
3500:
3330:
3272:
3223:
3155:
2991:
2933:
2885:
2876:
2839:
2792:
2754:
2741:
2333:
1744:
1634:
998:(above 14 pg/mL) was found associated with an increased 5-year event rate of
5833:
3369:
3204:
1227:
975:
925:
724:
653:
530:
A third mechanism may sometimes be operative. Due to the hypertrophy of the
423:
278:
208:
5332:
4201:
4130:
4095:
4036:
3951:
3853:
3804:
3763:
3714:
3662:
3616:
3572:
3436:
3387:
3338:
3280:
3231:
3163:
3089:
3071:
3009:
2951:
2893:
2800:
2687:
2634:
2530:
2412:
2351:
2294:
2253:
2210:
2089:
1950:
1909:
1849:
1795:
1752:
1696:
1652:
1587:
4076:
3992:
2695:
2588:
Morris, G.; Innasimuthu, A.L.; Fox, J.P.; Perry, R.A. (2 September 2009).
2310:"Acquired von Willebrand Syndrome Associated with Cardiovascular Diseases"
2224:
Miller JD (June 2013). "Cardiovascular calcification: Orbicular origins".
2124:
1900:
1883:
688:(CAVD) (>50% of cases), with a mean age of 65 to 70 years. CAVD is the
5120:
4277:
1312:
1270:
757:
645:
466:
242:
3305:"2021 ESC/EACTS Guidelines for the management of valvular heart disease"
3214:
3188:"2021 ESC/EACTS Guidelines for the management of valvular heart disease"
2769:"2021 ESC/EACTS Guidelines for the management of valvular heart disease"
2648:
Innasimuthu, A.; Morris, G.; Rao, G.; Fox, J.; Perry, R. (1 June 2007).
2325:
359:, with each having risks and benefits. Another less invasive procedure,
3795:
3778:
2521:
2504:
1568:
1308:
1243:
830:
406:
5733:
3696:
3607:
3554:
5745:
5200:
5180:
4335:
4168:
2505:"Pathogenesis and pathophysiology of aortic valve stenosis in adults"
2245:
2192:
1626:
439:
270:
112:
1884:"Aortic stenosis: new thoughts on a cardiac disease of older people"
1218:
Treatment is generally not necessary in people without symptoms. In
557:, a potentially lethal condition of which syncope may be a symptom.
684:
Aortic stenosis is most commonly caused by age-related progressive
2429:"CiruguĂa reparadora de la válvula aĂłrtica bicĂşspide insuficiente"
795:
787:
734:
675:
516:
289:. Thickening of the valve without causing obstruction is known as
254:
250:
66:
3730:"Minimally invasive aortic valve replacement: the "Miami Method""
632:
changed its recommendations regarding antibiotic prophylaxis for
2375:
Zhu, Z; Liu, Z; Zhang, D; Li, L; Pei, J; Cai, L (1 March 2024).
1163:
5336:
4241:
2377:"Models for calcific aortic valve disease in vivo and in vitro"
1349:
In adults, symptomatic severe aortic stenosis usually requires
604:. Recent research has shown that the stenosis causes a form of
3401:
Moura LM, Ramos SF, Zamorano JL, et al. (February 2007).
1288:
in patients with asymptomatic aortic stenosis and no manifest
668:
cannot be increased. Low blood pressure or syncope may ensue.
534:
in aortic stenosis, including the consequent inability of the
485:
3463:(4th ed.). Philadelphia: WB Saunders. pp. 1292–364.
1273:
are contraindicated due to their potential to cause profound
1242:
demonstrated an association between lowered cholesterol with
894:
Finally, aortic stenosis often co-exists with some degree of
815:
pulse may be of low volume. This is sometimes referred to as
3965:
Stewart BF, Siscovick D, Lind BK, et al. (March 1997).
2064:"Evaluation and management of patients with aortic stenosis"
857:
is heard loudest at the upper right sternal border, at the
3354:"Potential drug targets for calcific aortic valve disease"
1315:, and, if not contraindicated, cautious administration of
620:), due to increased turbulence around the stenotic valve.
3537:
Siemieniuk RA, Agoritsas T, Manja V, et al. (2016).
1396:
while pending surgery. In those with high blood pressure
304:; a normal valve may also harden over the decades due to
257:
begins), such that problems result. It may occur at the
660:. Note that all of these substances lead to peripheral
572:
with fibrosis, systolic dysfunction (a decrease in the
3679:
Foroutan F, Guyatt GH, O'Brien K, et al. (2016).
2267:
Figuinha, FC; Spina, GS; Tarasoutchi, F (March 2011).
1552:"Diagnosis and management of valvular aortic stenosis"
1072:
792:
Phonocardiograms from normal and abnormal heart sounds
506:. When a person with aortic stenosis exercises, their
4058:
Nathaniel S, Saligram S, Innasimuthu AL (June 2010).
2269:"Heyde's syndrome: case report and literature review"
2041:. Hagerstwon, MD: Lippincott Williams & Wilkins.
5723:
3461:
Heart disease: A textbook of cardiovascular medicine
701:
50+) than those with tricuspid aortic valves (65+).
484:(ST segment depression and T wave inversion) on the
434:. It may also be accompanied by the characteristic "
5813:
5727:
5647:
5593:
5533:
5524:
5492:
5474:
5456:
5433:
5379:
5370:
5287:
5230:
5139:
5106:
5078:
5036:
4995:
4972:
4946:
4914:
4872:
4853:
4752:
4738:
4638:
4592:
4578:
4494:
4443:
4436:
4373:
4328:
4285:
4276:
3777:Sef, D; Krajnc, M; Klokocovnik, T (February 2021).
2567:(3rd ed.). Lippincott Williams & Wilkins.
1816:"Cellular mechanisms of aortic valve calcification"
1404:may be used in those with very low blood pressure.
821:. There may also be a noticeable delay between the
810:Aortic stenosis is most often diagnosed when it is
515:will faint due to decreased blood perfusion to the
220:
207:
193:
181:
156:
142:
134:
122:
97:
85:
42:
27:
Narrowing of the exit of the heart's left ventricle
3352:Hutcheson JD, Aikawa E, Merryman WD (April 2014).
2034:
2027:
2025:
2023:
1201:condition, an enlarged left ventricle and atrium.
2021:
2019:
2017:
2015:
2013:
2011:
2009:
2007:
2005:
2003:
3924:Spaccarotella C, Mongiardo A, Indolfi C (2011).
2033:Elizabeth D Agabegi; Agabegi, Steven S. (2008).
1429:such as hypertension, advanced age, being male,
1365:Globally more than 250,000 people have received
986:due to progression of aortic valve stenosis, or
1888:Journal of the American Osteopathic Association
1726:
1160:
216:~50% without treatment in symptomatic patients
1724:
1722:
1720:
1718:
1716:
1714:
1712:
1710:
1708:
1706:
1022:Although aortic stenosis does not lead to any
477:branches. At this point there may be signs of
5348:
4253:
4180:Journal of the American College of Cardiology
4111:Journal of the American College of Cardiology
3971:Journal of the American College of Cardiology
3532:
3530:
3407:Journal of the American College of Cardiology
2856:Journal of the American College of Cardiology
1929:Journal of the American College of Cardiology
1669:Overgaard, CB; DzavĂk, V (2 September 2008).
1335:frequently for congenital aortic stenosis.
8:
5708:Anomalous aortic origin of a coronary artery
1307:Any heart failure is generally treated with
77:, cut lengthwise, is at the lower left. The
3899:. London: Informa Healthcare. p. 406.
3674:
3672:
3192:European Journal of Cardio-Thoracic Surgery
3102:: CS1 maint: numeric names: authors list (
2669:
2667:
1392:due to AS may be temporarily managed by an
853:, crescendo-decrescendo (i.e., 'ejection')
422:or other symptoms of heart failure such as
5724:
5530:
5376:
5355:
5341:
5333:
4869:
4749:
4589:
4570:Arrhythmogenic right ventricular dysplasia
4440:
4282:
4260:
4246:
4238:
3584:
3582:
2755:https://www.ncbi.nlm.nih.gov/books/NBK342/
2742:https://www.ncbi.nlm.nih.gov/books/NBK345/
1877:
1875:
1873:
1871:
1869:
1867:
1865:
1863:
1861:
1859:
1809:
1807:
1805:
1664:
1662:
752:blood in the aorta from flowing backward (
510:will decrease as the blood vessels of the
457:Angina in the setting of AS occurs due to
48:
39:
4191:
4085:
4075:
3982:
3941:
3843:
3794:
3753:
3704:
3652:
3606:
3562:
3426:
3377:
3320:
3262:
3213:
3203:
3145:
3079:
2999:
2941:
2875:
2605:
2520:
2444:
2402:
2392:
2341:
2314:Journal of Atherosclerosis and Thrombosis
2284:
2200:
2079:
1940:
1899:
1839:
1820:Circulation: Cardiovascular Interventions
1686:
1642:
1577:
1567:
1545:
1543:
1541:
1539:
1537:
1535:
1533:
1531:
1529:
1527:
1525:
1523:
1521:
1519:
1517:
1515:
1513:
1511:
1509:
1507:
1505:
1503:
1501:
1499:
1043:electrical conduction system of the heart
551:electrical conduction system of the heart
4158:) is being considered for deletion. See
4005:clinical Anesthesiology by Edward Morgan
1497:
1495:
1493:
1491:
1489:
1487:
1485:
1483:
1481:
1479:
972:N-terminal pro-brain natriuretic peptide
546:may develop. These can lead to syncope.
428:episodes of shortness of breath at night
2498:
2496:
2494:
2492:
2490:
2480:
2478:
2476:
1475:
1367:transcatheter aortic valve intervention
871:hypertrophic obstructive cardiomyopathy
580:(elevated filling pressure of the LV).
312:. Risk factors are similar to those of
81:, also cut lengthwise, is on the right.
4304:Spontaneous coronary artery dissection
3095:
2474:
2472:
2470:
2468:
2466:
2464:
2462:
2460:
2458:
2456:
1556:Clinical Medicine Insights. Cardiology
1361:Transcatheter aortic valve replacement
680:Illustration depicting aortic stenosis
349:transcatheter aortic valve replacement
224:2% of people over 65 (developed world)
2162:
2160:
1261:Any angina is generally treated with
829:) and the corresponding pulse in the
592:, aortic stenosis is associated with
7:
4628:Nonbacterial thrombotic endocarditis
2509:Polish Archives of Internal Medicine
2503:Olszowska, Maria (1 November 2011).
2037:Step-Up to Medicine (Step-Up Series)
1969:The Lecturio Medical Concept Library
1832:10.1161/CIRCINTERVENTIONS.112.971028
1413:older than 65 it is about the same.
692:on the cusps of the valve, and this
553:. If that occurs, the result may be
424:shortness of breath while lying flat
3746:10.3978/j.issn.2225-319X.2014.12.10
2381:Cell Regeneration (London, England)
2273:Arquivos Brasileiros de Cardiologia
1776:Progress in Cardiovascular Diseases
1219:
628:Notwithstanding the foregoing, the
390:Aortic stenosis is the most common
65:. The valve is … surrounded by the
5443:Sinus venosus atrial septal defect
5401:Transposition of the great vessels
4924:Accelerated idioventricular rhythm
3832:JACC. Cardiovascular Interventions
2832:10.1161/01.CIR.0000126825.50903.18
2623:The Journal of Heart Valve Disease
2081:10.1161/01.cir.0000015343.76143.13
1008:percutaneous coronary intervention
869:, which helps distinguish it from
739:Density-dependent colour scanning
538:to adequately supply blood to the
25:
4162:to help reach a consensus. ›
3493:10.1161/CIRCULATIONAHA.115.021213
1688:10.1161/CIRCULATIONAHA.107.728840
1390:Acute decompensated heart failure
1246:and decreased progression, but a
616:-associated antigen, also called
420:shortness of breath with activity
387:depending on the blood pressure.
296:Causes include being born with a
4211:
4029:10.1111/j.1540-8175.2010.01256.x
3913:from the original on 2015-04-02.
3893:Christopher M. O'Connor (2005).
3734:Annals of Cardiothoracic Surgery
3654:10.1016/j.athoracsur.2014.06.050
3623:from the original on 2016-10-05.
2564:Pathophysiology of Heart Disease
968:aortic valve replacement surgery
928:, which is not displaced unless
920:Other peripheral signs include:
608:by breaking down its associated
4609:Subacute bacterial endocarditis
2709:Lilly, Leonard S., ed. (2007).
2446:10.4067/S0034-98872005000300002
2286:10.1590/S0066-782X2011000300017
1062:Cardiac chamber catheterization
103:Decreased ability to exercise,
5476:Atrioventricular septal defect
3641:The Annals of Thoracic Surgery
3037:Yale atlas of echocardiography
1550:Czarny, MJ; Resar, JR (2014).
1012:coronary artery bypass surgery
508:peripheral vascular resistance
1:
5418:Persistent truncus arteriosus
5389:Double outlet right ventricle
5126:Pulseless electrical activity
5055:Multifocal atrial tachycardia
4929:Catecholaminergic polymorphic
3984:10.1016/S0735-1097(96)00563-3
2117:10.1016/S0140-6736(84)91555-1
1942:10.1016/s0735-1097(99)00027-3
1149:The aortic valve area can be
686:calcific aortic valve disease
5381:Aortopulmonary septal defect
4060:"Aortic stenosis: An update"
3251:JACC: Cardiovascular Imaging
3147:10.1161/CIR.0000000000000923
3056:"Echocardiography in adults"
2984:10.1016/j.eclinm.2023.101875
2926:10.1001/jamacardio.2021.5916
2062:Blase A. Carabello. (2002).
1923:Silverman, ME (April 1999).
1882:Rogers, FJ (November 2013).
1032:left ventricular hypertrophy
713:systemic lupus erythematosus
570:left ventricular hypertrophy
459:left ventricular hypertrophy
361:balloon aortic valvuloplasty
338:ultrasound scan of the heart
202:balloon aortic valvuloplasty
61:with severe stenosis due to
4064:World Journal of Cardiology
3728:Lamelas, J (January 2015).
1077:Severity of aortic stenosis
966:and optimize the timing of
859:2nd right intercostal space
721:high blood uric acid levels
385:decompensated heart failure
73:is at the upper right. The
5893:
5070:Wandering atrial pacemaker
4617:non-infective endocarditis
4558:Endocardial fibroelastosis
4193:10.1016/j.jacc.2017.09.018
4123:10.1016/j.jacc.2012.01.024
3845:10.1016/j.jcin.2020.09.063
3783:Journal of Cardiac Surgery
3419:10.1016/j.jacc.2006.07.072
3264:10.1016/j.jcmg.2019.01.045
3060:Journal of Ultrasonography
2868:10.1016/j.jacc.2014.02.581
2394:10.1186/s13619-024-00189-8
1814:Leopold JA (August 2012).
1788:10.1016/j.pcad.2014.02.006
1377:For infants and children,
1342:
1327:
956:B-type natriuretic peptide
630:American Heart Association
383:may be used in those with
29:
5458:Ventricular septal defect
5148:hexaxial reference system
5093:Jervell and Lange-Nielsen
4623:Libman–Sacks endocarditis
3358:Nature Reviews Cardiology
3322:10.1093/eurheartj/ehab395
2785:10.1093/eurheartj/ehab395
1394:intra-aortic balloon pump
1248:randomized clinical trial
1075:
885:left ventricular pressure
843:lower left sternal border
594:gastrointestinal bleeding
345:valve replacement surgery
79:left main coronary artery
56:
47:
5364:Congenital heart defects
5028:Ventricular fibrillation
4299:Coronary artery aneurysm
4160:templates for discussion
3943:10.1253/circj.CJ-10-1105
3033:"Senile aortic stenosis"
2607:10.1093/eurheartj/ehp415
1745:10.1001/jama.2013.279194
1443:end-stage kidney disease
1351:aortic valve replacement
1345:Aortic valve replacement
1339:Aortic valve replacement
1302:diastolic blood pressure
1231:therapeutic approaches.
1162:Gradient = 4(velocity)²
1051:Left bundle branch block
988:aortic valve replacement
876:The second heart sound (
566:Congestive heart failure
561:Congestive heart failure
285:, or with exercise, and
271:heart related chest pain
198:Aortic valve replacement
113:heart related chest pain
32:Coarctation of the aorta
30:Not to be confused with
5703:Coronary artery anomaly
5305:Diastolic heart failure
5279:Athletic heart syndrome
5240:Ventricular hypertrophy
4974:Pre-excitation syndrome
4828:Left posterior fascicle
4353:Acute coronary syndrome
4293:Coronary artery disease
3370:10.1038/nrcardio.2014.1
2433:Revista médica de Chile
1427:coronary artery disease
1400:may be carefully used.
1298:systolic blood pressure
1290:atherosclerotic disease
1000:ischemic cardiac events
992:coronary artery disease
982:, hospitalization with
945:narrowed pulse pressure
818:pulsus parvus et tardus
410:of aortic stenosis are
314:coronary artery disease
188:Ultrasound of the heart
63:rheumatic heart disease
5872:Valvular heart disease
5526:Valvular heart disease
5505:Cyanotic heart disease
5448:Lutembacher's syndrome
4823:Left anterior fascicle
4603:infective endocarditis
4388:Hibernating myocardium
4269:Cardiovascular disease
3309:European Heart Journal
3072:10.15557/JoU.2019.0008
3039:. 1999. Archived from
2773:European Heart Journal
2688:10.1001/jama.277.7.564
2594:European Heart Journal
2561:Lilly LS, ed. (2003).
1300:of 130-139 mmHg and a
1167:
962:) measurements to aid
861:, and radiates to the
802:
793:
744:
681:
606:von Willebrand disease
544:abnormal heart rhythms
542:(see "Angina" below),
392:valvular heart disease
5877:Diseases of the aorta
5713:Ventricular inversion
5425:Aortopulmonary window
5394:Taussig–Bing syndrome
4987:Wolff–Parkinson–White
4947:Premature contraction
4845:Adams–Stokes syndrome
4548:Loeffler endocarditis
4358:Myocardial infarction
4077:10.4330/wjc.v2.i6.135
3514:Hans-Joachim Schäfers
3205:10.1093/ejcts/ezab389
3043:on November 30, 2012.
2600:(Supplement 1): 682.
1901:10.7556/jaoa.2013.057
1437:, cigarette smoking,
1379:balloon valvuloplasty
1373:Balloon valvuloplasty
1240:Observational studies
1057:Heart catheterization
1004:myocardial infarction
799:
791:
738:
705:Acute rheumatic fever
698:bicuspid aortic valve
679:
618:von Willebrand factor
578:diastolic dysfunction
432:swollen legs and feet
412:loss of consciousness
298:bicuspid aortic valve
267:loss of consciousness
147:Bicuspid aortic valve
105:loss of consciousness
75:right coronary artery
18:Aortic valve stenosis
5512:Eisenmenger syndrome
5435:Atrial septal defect
5154:Right axis deviation
5116:Sudden cardiac death
4474:Pericardial effusion
4417:Ventricular aneurysm
1180:aortic regurgitation
1156:Bernoulli's equation
980:cardiovascular death
930:systolic dysfunction
900:aortic regurgitation
896:aortic insufficiency
287:swelling of the legs
5466:Tetralogy of Fallot
5372:Heart septal defect
5159:Left axis deviation
5016:Atrial fibrillation
5011:Ventricular flutter
4934:Torsades de pointes
4808:Bundle branch block
4767:Sick sinus syndrome
4553:Cardiac amyloidosis
4538:Tachycardia-induced
4393:Myocardial stunning
4341:Prinzmetal's angina
4310:Coronary thrombosis
3930:Circulation Journal
3882:. 26 February 2021.
2326:10.5551/jat.RV17031
2238:2013NatMa..12..476M
2185:2013NatMa..12..576B
2111:(8412): 1113–1116.
1619:2013NatMa..12..576B
1330:Aortic valve repair
1324:Aortic valve repair
1277:in aortic stenosis.
1224:cardiac stress test
1205:Computer tomography
964:risk stratification
924:sustained, heaving
741:electron micrograph
690:build-up of calcium
584:Associated symptoms
322:high blood pressure
275:shortness of breath
245:of the exit of the
167:high blood pressure
109:shortness of breath
5814:External resources
5262:Atrial enlargement
5060:Pacemaker syndrome
4982:Lown–Ganong–Levine
4904:Junctional ectopic
4899:AV nodal reentrant
4405:Myocardial rupture
4315:Coronary vasospasm
3796:10.1111/jocs.15257
2522:10.20452/pamw.1103
1569:10.4137/CMC.S15716
1562:(Suppl 1): 15–24.
1439:metabolic syndrome
1296:was found to be a
889:fourth heart sound
803:
794:
745:
682:
402:Signs and symptoms
214:Five-year survival
5859:
5858:
5721:
5720:
5643:
5642:
5583:Ebstein's anomaly
5520:
5519:
5330:
5329:
5322:Obstructive shock
5226:
5225:
5173:Short QT syndrome
5140:Other / ungrouped
5131:Sinoatrial arrest
5046:Ectopic pacemaker
4942:
4941:
4762:Sinus bradycardia
4734:
4733:
4730:
4729:
4479:Cardiac tamponade
4432:
4431:
4422:Dressler syndrome
4320:Myocardial bridge
4186:(20): 2566–2598.
3697:10.1136/bmj.i5065
3608:10.1136/bmj.i5085
3555:10.1136/bmj.i5130
3522:978-3-8374-1406-6
2972:eClinicalMedicine
2877:20.500.11794/2068
2862:(19): 2016–2025.
2826:(19): 2302–2308.
2726:978-0-7817-6321-9
2574:978-0-7817-4027-2
2074:(15): 1746–1750.
2048:978-0-7817-7153-5
1965:"Aortic Stenosis"
1435:diabetes mellitus
1294:diabetes mellitus
1141:
1140:
1091:Aortic valve area
1028:electrocardiogram
1018:Electrocardiogram
941:precordial thrill
904:pulsus bisferiens
867:Valsalva maneuver
823:first heart sound
762:endothelial cells
574:ejection fraction
536:coronary arteries
228:
227:
183:Diagnostic method
57:In the center an
37:Medical condition
16:(Redirected from
5884:
5725:
5698:Brugada syndrome
5693:Crisscross heart
5563:tricuspid valves
5541:pulmonary valves
5531:
5377:
5357:
5350:
5343:
5334:
5295:Cardiac fibrosis
5187:T wave alternans
5080:Long QT syndrome
4874:Supraventricular
4870:
4803:Intraventricular
4750:
4590:
4441:
4286:Coronary disease
4283:
4262:
4255:
4248:
4239:
4215:
4214:
4205:
4195:
4135:
4134:
4106:
4100:
4099:
4089:
4079:
4055:
4049:
4048:
4017:Echocardiography
4012:
4006:
4003:
3997:
3996:
3986:
3962:
3956:
3955:
3945:
3921:
3915:
3914:
3890:
3884:
3883:
3872:
3866:
3865:
3847:
3823:
3817:
3816:
3798:
3774:
3768:
3767:
3757:
3725:
3719:
3718:
3708:
3676:
3667:
3666:
3656:
3631:
3625:
3624:
3610:
3586:
3577:
3576:
3566:
3534:
3525:
3511:
3505:
3504:
3471:
3465:
3464:
3456:
3450:
3447:
3441:
3440:
3430:
3398:
3392:
3391:
3381:
3349:
3343:
3342:
3324:
3299:
3293:
3292:
3266:
3257:(9): 1835–1848.
3242:
3236:
3235:
3217:
3207:
3182:
3176:
3175:
3149:
3124:
3118:
3114:
3108:
3107:
3101:
3093:
3083:
3051:
3045:
3044:
3029:
3023:
3020:
3014:
3013:
3003:
2962:
2956:
2955:
2945:
2904:
2898:
2897:
2879:
2850:
2844:
2843:
2811:
2805:
2804:
2763:
2757:
2750:
2744:
2737:
2731:
2730:
2706:
2700:
2699:
2671:
2662:
2661:
2645:
2639:
2638:
2618:
2612:
2611:
2609:
2585:
2579:
2578:
2558:
2552:
2549:
2543:
2542:
2524:
2500:
2485:
2482:
2451:
2450:
2448:
2423:
2417:
2416:
2406:
2396:
2372:
2366:
2362:
2356:
2355:
2345:
2305:
2299:
2298:
2288:
2264:
2258:
2257:
2246:10.1038/nmat3663
2226:Nature Materials
2221:
2215:
2214:
2204:
2193:10.1038/nmat3627
2173:Nature Materials
2164:
2155:
2152:
2146:
2143:
2137:
2136:
2100:
2094:
2093:
2083:
2059:
2053:
2052:
2040:
2029:
1998:
1995:
1989:
1986:
1980:
1979:
1977:
1975:
1961:
1955:
1954:
1944:
1920:
1914:
1913:
1903:
1879:
1854:
1853:
1843:
1811:
1800:
1799:
1771:
1765:
1764:
1728:
1701:
1700:
1690:
1666:
1657:
1656:
1646:
1627:10.1038/nmat3627
1607:Nature Materials
1598:
1592:
1591:
1581:
1571:
1547:
1267:calcium blockers
1073:
1026:findings on the
994:, the increased
915:likelihood ratio
863:carotid arteries
849:An easily heard
590:Heyde's syndrome
512:skeletal muscles
438:" appearance of
326:high cholesterol
310:developing world
291:aortic sclerosis
277:especially when
171:high cholesterol
52:
40:
21:
5892:
5891:
5887:
5886:
5885:
5883:
5882:
5881:
5862:
5861:
5860:
5855:
5854:
5850:Aortic stenosis
5809:
5808:
5736:
5722:
5717:
5688:Cor triatriatum
5654:Underdeveloped
5639:
5589:
5516:
5488:
5470:
5452:
5429:
5366:
5361:
5331:
5326:
5317:Rheumatic fever
5283:
5222:
5135:
5102:
5074:
5032:
4991:
4968:
4938:
4910:
4857:
4849:
4743:
4726:
4634:
4583:
4574:
4490:
4484:Hemopericardium
4428:
4369:
4363:Unstable angina
4336:Angina pectoris
4329:Active ischemia
4324:
4272:
4266:
4236:
4235:
4234:
4229:Aortic stenosis
4216:
4212:
4173:
4165:Aortic stenosis
4163:
4144:
4139:
4138:
4108:
4107:
4103:
4057:
4056:
4052:
4014:
4013:
4009:
4004:
4000:
3964:
3963:
3959:
3923:
3922:
3918:
3907:
3892:
3891:
3887:
3874:
3873:
3869:
3825:
3824:
3820:
3776:
3775:
3771:
3727:
3726:
3722:
3678:
3677:
3670:
3633:
3632:
3628:
3588:
3587:
3580:
3536:
3535:
3528:
3512:
3508:
3473:
3472:
3468:
3458:
3457:
3453:
3448:
3444:
3400:
3399:
3395:
3351:
3350:
3346:
3301:
3300:
3296:
3244:
3243:
3239:
3184:
3183:
3179:
3140:(5): e72–e227.
3126:
3125:
3121:
3115:
3111:
3094:
3053:
3052:
3048:
3031:
3030:
3026:
3021:
3017:
2964:
2963:
2959:
2914:JAMA Cardiology
2906:
2905:
2901:
2852:
2851:
2847:
2813:
2812:
2808:
2765:
2764:
2760:
2751:
2747:
2738:
2734:
2727:
2708:
2707:
2703:
2673:
2672:
2665:
2660:(suppl 1): A39.
2647:
2646:
2642:
2620:
2619:
2615:
2587:
2586:
2582:
2575:
2560:
2559:
2555:
2550:
2546:
2515:(11): 409–413.
2502:
2501:
2488:
2483:
2454:
2425:
2424:
2420:
2374:
2373:
2369:
2363:
2359:
2307:
2306:
2302:
2266:
2265:
2261:
2223:
2222:
2218:
2166:
2165:
2158:
2153:
2149:
2144:
2140:
2102:
2101:
2097:
2061:
2060:
2056:
2049:
2032:
2030:
2001:
1996:
1992:
1987:
1983:
1973:
1971:
1963:
1962:
1958:
1922:
1921:
1917:
1894:(11): 820–828.
1881:
1880:
1857:
1813:
1812:
1803:
1773:
1772:
1768:
1730:
1729:
1704:
1681:(10): 1047–56.
1668:
1667:
1660:
1600:
1599:
1595:
1549:
1548:
1477:
1472:
1463:bisphosphonates
1459:
1451:
1419:
1410:
1387:
1375:
1363:
1347:
1341:
1332:
1326:
1237:
1216:
1207:
1191:
1172:mitral stenosis
1092:
1087:
1071:
1059:
1020:
952:
909:According to a
881:
839:
808:
786:
766:LDL cholesterol
733:
731:Pathophysiology
674:
626:
586:
563:
494:
475:coronary artery
452:
418:chest pain and
404:
396:developed world
302:rheumatic fever
231:Aortic stenosis
151:rheumatic fever
92:Cardiac surgery
71:pulmonary trunk
43:Aortic stenosis
38:
35:
28:
23:
22:
15:
12:
11:
5:
5890:
5888:
5880:
5879:
5874:
5864:
5863:
5857:
5856:
5853:
5852:
5841:
5830:
5818:
5817:
5815:
5811:
5810:
5807:
5806:
5795:
5784:
5761:
5737:
5732:
5731:
5729:
5728:Classification
5719:
5718:
5716:
5715:
5710:
5705:
5700:
5695:
5690:
5685:
5680:
5675:
5674:
5673:
5668:
5663:
5656:heart chambers
5651:
5649:
5645:
5644:
5641:
5640:
5638:
5637:
5636:
5635:
5630:
5620:
5619:
5618:
5613:
5608:
5597:
5595:
5591:
5590:
5588:
5587:
5586:
5585:
5580:
5575:
5570:
5560:
5559:
5558:
5553:
5548:
5537:
5535:
5528:
5522:
5521:
5518:
5517:
5515:
5514:
5509:
5508:
5507:
5496:
5494:
5490:
5489:
5487:
5486:
5480:
5478:
5472:
5471:
5469:
5468:
5462:
5460:
5454:
5453:
5451:
5450:
5445:
5439:
5437:
5431:
5430:
5428:
5427:
5421:
5420:
5415:
5414:
5413:
5408:
5398:
5397:
5396:
5385:
5383:
5374:
5368:
5367:
5362:
5360:
5359:
5352:
5345:
5337:
5328:
5327:
5325:
5324:
5319:
5314:
5313:
5312:
5310:Cardiac asthma
5307:
5297:
5291:
5289:
5285:
5284:
5282:
5281:
5276:
5275:
5274:
5269:
5259:
5258:
5257:
5252:
5247:
5236:
5234:
5228:
5227:
5224:
5223:
5221:
5220:
5218:Strain pattern
5215:
5214:
5213:
5208:
5203:
5191:
5190:
5189:
5177:
5176:
5175:
5163:
5162:
5161:
5156:
5143:
5141:
5137:
5136:
5134:
5133:
5128:
5123:
5118:
5112:
5110:
5108:Cardiac arrest
5104:
5103:
5101:
5100:
5095:
5090:
5088:Andersen–Tawil
5084:
5082:
5076:
5075:
5073:
5072:
5067:
5062:
5057:
5052:
5042:
5040:
5034:
5033:
5031:
5030:
5025:
5024:
5023:
5013:
5008:
5006:Atrial flutter
5002:
5000:
4993:
4992:
4990:
4989:
4984:
4978:
4976:
4970:
4969:
4967:
4966:
4961:
4956:
4950:
4948:
4944:
4943:
4940:
4939:
4937:
4936:
4931:
4926:
4920:
4918:
4912:
4911:
4909:
4908:
4907:
4906:
4901:
4891:
4890:
4889:
4878:
4876:
4867:
4851:
4850:
4848:
4847:
4842:
4841:
4840:
4835:
4830:
4825:
4820:
4815:
4805:
4800:
4799:
4798:
4793:
4788:
4778:
4769:
4764:
4758:
4756:
4747:
4736:
4735:
4732:
4731:
4728:
4727:
4725:
4724:
4723:
4722:
4717:
4705:
4704:
4703:
4698:
4686:
4685:
4684:
4679:
4667:
4666:
4665:
4660:
4655:
4642:
4640:
4636:
4635:
4633:
4632:
4631:
4630:
4625:
4613:
4612:
4611:
4598:
4596:
4587:
4576:
4575:
4573:
4572:
4567:
4566:
4565:
4560:
4555:
4550:
4545:
4540:
4535:
4530:
4529:
4528:
4516:Cardiomyopathy
4513:
4512:
4511:
4509:Chagas disease
4500:
4498:
4492:
4491:
4489:
4488:
4487:
4486:
4481:
4471:
4470:
4469:
4460:
4449:
4447:
4438:
4434:
4433:
4430:
4429:
4427:
4426:
4425:
4424:
4419:
4409:
4408:
4407:
4397:
4396:
4395:
4390:
4379:
4377:
4371:
4370:
4368:
4367:
4366:
4365:
4360:
4350:
4349:
4348:
4343:
4332:
4330:
4326:
4325:
4323:
4322:
4317:
4312:
4307:
4301:
4296:
4289:
4287:
4280:
4274:
4273:
4267:
4265:
4264:
4257:
4250:
4242:
4217:
4210:
4209:
4208:
4207:
4206:
4171:
4147:
4143:
4142:External links
4140:
4137:
4136:
4117:(16): 1452–9.
4101:
4050:
4007:
3998:
3957:
3916:
3905:
3885:
3867:
3838:(2): 115–134.
3818:
3789:(2): 558–564.
3769:
3720:
3668:
3626:
3578:
3526:
3506:
3487:(6): 455–468.
3466:
3451:
3442:
3393:
3344:
3315:(7): 561–632.
3294:
3237:
3198:(4): 727–800.
3177:
3119:
3109:
3046:
3024:
3015:
2957:
2920:(4): 435–444.
2899:
2845:
2806:
2779:(7): 561–632.
2758:
2745:
2732:
2725:
2701:
2663:
2640:
2613:
2580:
2573:
2553:
2544:
2486:
2452:
2418:
2367:
2357:
2320:(4): 303–314.
2300:
2279:(3): e42–e45.
2259:
2216:
2156:
2147:
2138:
2095:
2054:
2047:
1999:
1990:
1981:
1956:
1935:(5): 1141–51.
1915:
1855:
1801:
1766:
1739:(14): 1490–7.
1702:
1658:
1613:(6): 576–583.
1593:
1474:
1473:
1471:
1468:
1458:
1455:
1450:
1447:
1431:hyperlipidemia
1418:
1415:
1409:
1406:
1386:
1383:
1374:
1371:
1362:
1359:
1343:Main article:
1340:
1337:
1328:Main article:
1325:
1322:
1321:
1320:
1317:ACE inhibitors
1305:
1304:of 70-90 mmHg.
1286:blood pressure
1278:
1236:
1233:
1220:moderate cases
1215:
1212:
1206:
1203:
1190:
1187:
1178:, co-existent
1144:Echocardiogram
1139:
1138:
1135:
1132:
1128:
1127:
1124:
1121:
1117:
1116:
1113:
1110:
1106:
1105:
1102:
1099:
1095:
1094:
1089:
1086:Mean gradient
1084:
1080:
1079:
1070:
1069:Echocardiogram
1067:
1058:
1055:
1036:left ventricle
1019:
1016:
951:
948:
947:
946:
943:
937:
934:left ventricle
879:
838:
835:
807:
804:
785:
782:
770:lipoprotein(a)
732:
729:
673:
670:
666:cardiac output
656:(Hytrin), and
650:ACE inhibitors
625:
622:
598:angiodysplasia
585:
582:
562:
559:
532:left ventricle
504:cardiac output
493:
490:
481:strain pattern
463:muscular layer
451:
448:
403:
400:
365:ACE inhibitors
247:left ventricle
226:
225:
222:
218:
217:
211:
205:
204:
195:
191:
190:
185:
179:
178:
160:
154:
153:
144:
140:
139:
136:
132:
131:
126:
120:
119:
101:
95:
94:
89:
83:
82:
54:
53:
45:
44:
36:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
5889:
5878:
5875:
5873:
5870:
5869:
5867:
5851:
5847:
5846:
5842:
5840:
5836:
5835:
5831:
5829:
5825:
5824:
5820:
5819:
5816:
5812:
5805:
5801:
5800:
5796:
5794:
5790:
5789:
5785:
5783:
5779:
5775:
5771:
5770:
5766:
5762:
5760:
5756:
5752:
5748:
5747:
5743:
5739:
5738:
5735:
5730:
5726:
5714:
5711:
5709:
5706:
5704:
5701:
5699:
5696:
5694:
5691:
5689:
5686:
5684:
5681:
5679:
5676:
5672:
5669:
5667:
5664:
5662:
5659:
5658:
5657:
5653:
5652:
5650:
5646:
5634:
5633:regurgitation
5631:
5629:
5626:
5625:
5624:
5623:mitral valves
5621:
5617:
5614:
5612:
5611:insufficiency
5609:
5607:
5604:
5603:
5602:
5601:aortic valves
5599:
5598:
5596:
5592:
5584:
5581:
5579:
5576:
5574:
5573:regurgitation
5571:
5569:
5566:
5565:
5564:
5561:
5557:
5554:
5552:
5551:insufficiency
5549:
5547:
5544:
5543:
5542:
5539:
5538:
5536:
5532:
5529:
5527:
5523:
5513:
5510:
5506:
5503:
5502:
5501:
5500:Cardiac shunt
5498:
5497:
5495:
5491:
5485:
5484:Ostium primum
5482:
5481:
5479:
5477:
5473:
5467:
5464:
5463:
5461:
5459:
5455:
5449:
5446:
5444:
5441:
5440:
5438:
5436:
5432:
5426:
5423:
5422:
5419:
5416:
5412:
5409:
5407:
5404:
5403:
5402:
5399:
5395:
5392:
5391:
5390:
5387:
5386:
5384:
5382:
5378:
5375:
5373:
5369:
5365:
5358:
5353:
5351:
5346:
5344:
5339:
5338:
5335:
5323:
5320:
5318:
5315:
5311:
5308:
5306:
5303:
5302:
5301:
5300:Heart failure
5298:
5296:
5293:
5292:
5290:
5286:
5280:
5277:
5273:
5270:
5268:
5265:
5264:
5263:
5260:
5256:
5253:
5251:
5248:
5246:
5243:
5242:
5241:
5238:
5237:
5235:
5233:
5229:
5219:
5216:
5212:
5211:ST depression
5209:
5207:
5204:
5202:
5199:
5198:
5197:
5196:
5192:
5188:
5185:
5184:
5183:
5182:
5178:
5174:
5171:
5170:
5169:
5168:
5164:
5160:
5157:
5155:
5152:
5151:
5150:
5149:
5145:
5144:
5142:
5138:
5132:
5129:
5127:
5124:
5122:
5119:
5117:
5114:
5113:
5111:
5109:
5105:
5099:
5096:
5094:
5091:
5089:
5086:
5085:
5083:
5081:
5077:
5071:
5068:
5066:
5063:
5061:
5058:
5056:
5053:
5051:
5047:
5044:
5043:
5041:
5039:
5035:
5029:
5026:
5022:
5019:
5018:
5017:
5014:
5012:
5009:
5007:
5004:
5003:
5001:
4999:
4994:
4988:
4985:
4983:
4980:
4979:
4977:
4975:
4971:
4965:
4962:
4960:
4957:
4955:
4952:
4951:
4949:
4945:
4935:
4932:
4930:
4927:
4925:
4922:
4921:
4919:
4917:
4913:
4905:
4902:
4900:
4897:
4896:
4895:
4892:
4888:
4885:
4884:
4883:
4880:
4879:
4877:
4875:
4871:
4868:
4865:
4861:
4856:
4852:
4846:
4843:
4839:
4838:Trifascicular
4836:
4834:
4831:
4829:
4826:
4824:
4821:
4819:
4816:
4814:
4811:
4810:
4809:
4806:
4804:
4801:
4797:
4794:
4792:
4789:
4787:
4784:
4783:
4782:
4779:
4777:
4773:
4770:
4768:
4765:
4763:
4760:
4759:
4757:
4755:
4751:
4748:
4746:
4741:
4737:
4721:
4720:regurgitation
4718:
4716:
4713:
4712:
4711:
4710:
4706:
4702:
4701:regurgitation
4699:
4697:
4694:
4693:
4692:
4691:
4687:
4683:
4682:regurgitation
4680:
4678:
4675:
4674:
4673:
4672:
4668:
4664:
4663:regurgitation
4661:
4659:
4656:
4654:
4651:
4650:
4649:
4648:
4644:
4643:
4641:
4637:
4629:
4626:
4624:
4621:
4620:
4619:
4618:
4614:
4610:
4607:
4606:
4605:
4604:
4600:
4599:
4597:
4595:
4591:
4588:
4586:
4581:
4577:
4571:
4568:
4564:
4561:
4559:
4556:
4554:
4551:
4549:
4546:
4544:
4541:
4539:
4536:
4534:
4531:
4527:
4524:
4523:
4522:
4519:
4518:
4517:
4514:
4510:
4507:
4506:
4505:
4502:
4501:
4499:
4497:
4493:
4485:
4482:
4480:
4477:
4476:
4475:
4472:
4468:
4464:
4461:
4459:
4456:
4455:
4454:
4451:
4450:
4448:
4446:
4442:
4439:
4435:
4423:
4420:
4418:
4415:
4414:
4413:
4410:
4406:
4403:
4402:
4401:
4398:
4394:
4391:
4389:
4386:
4385:
4384:
4381:
4380:
4378:
4376:
4372:
4364:
4361:
4359:
4356:
4355:
4354:
4351:
4347:
4346:Stable angina
4344:
4342:
4339:
4338:
4337:
4334:
4333:
4331:
4327:
4321:
4318:
4316:
4313:
4311:
4308:
4305:
4302:
4300:
4297:
4294:
4291:
4290:
4288:
4284:
4281:
4279:
4275:
4270:
4263:
4258:
4256:
4251:
4249:
4244:
4243:
4240:
4232:
4231:
4230:
4224:
4220:
4203:
4199:
4194:
4189:
4185:
4181:
4177:
4172:
4170:
4166:
4161:
4157:
4156:
4151:
4146:
4145:
4141:
4132:
4128:
4124:
4120:
4116:
4112:
4105:
4102:
4097:
4093:
4088:
4083:
4078:
4073:
4069:
4065:
4061:
4054:
4051:
4046:
4042:
4038:
4034:
4030:
4026:
4022:
4018:
4011:
4008:
4002:
3999:
3994:
3990:
3985:
3980:
3976:
3972:
3968:
3961:
3958:
3953:
3949:
3944:
3939:
3935:
3931:
3927:
3920:
3917:
3912:
3908:
3906:9780203421345
3902:
3898:
3897:
3889:
3886:
3881:
3877:
3871:
3868:
3863:
3859:
3855:
3851:
3846:
3841:
3837:
3833:
3829:
3822:
3819:
3814:
3810:
3806:
3802:
3797:
3792:
3788:
3784:
3780:
3773:
3770:
3765:
3761:
3756:
3751:
3747:
3743:
3739:
3735:
3731:
3724:
3721:
3716:
3712:
3707:
3702:
3698:
3694:
3690:
3686:
3682:
3675:
3673:
3669:
3664:
3660:
3655:
3650:
3646:
3642:
3638:
3630:
3627:
3622:
3618:
3614:
3609:
3604:
3600:
3596:
3592:
3585:
3583:
3579:
3574:
3570:
3565:
3560:
3556:
3552:
3548:
3544:
3540:
3533:
3531:
3527:
3523:
3519:
3515:
3510:
3507:
3502:
3498:
3494:
3490:
3486:
3482:
3478:
3470:
3467:
3462:
3455:
3452:
3446:
3443:
3438:
3434:
3429:
3424:
3420:
3416:
3413:(5): 554–61.
3412:
3408:
3404:
3397:
3394:
3389:
3385:
3380:
3375:
3371:
3367:
3364:(4): 218–31.
3363:
3359:
3355:
3348:
3345:
3340:
3336:
3332:
3328:
3323:
3318:
3314:
3310:
3306:
3298:
3295:
3290:
3286:
3282:
3278:
3274:
3270:
3265:
3260:
3256:
3252:
3248:
3241:
3238:
3233:
3229:
3225:
3221:
3216:
3211:
3206:
3201:
3197:
3193:
3189:
3181:
3178:
3173:
3169:
3165:
3161:
3157:
3153:
3148:
3143:
3139:
3135:
3131:
3123:
3120:
3113:
3110:
3105:
3099:
3091:
3087:
3082:
3077:
3073:
3069:
3066:(76): 54–61.
3065:
3061:
3057:
3050:
3047:
3042:
3038:
3034:
3028:
3025:
3019:
3016:
3011:
3007:
3002:
2997:
2993:
2989:
2985:
2981:
2977:
2973:
2969:
2961:
2958:
2953:
2949:
2944:
2939:
2935:
2931:
2927:
2923:
2919:
2915:
2911:
2903:
2900:
2895:
2891:
2887:
2883:
2878:
2873:
2869:
2865:
2861:
2857:
2849:
2846:
2841:
2837:
2833:
2829:
2825:
2821:
2817:
2810:
2807:
2802:
2798:
2794:
2790:
2786:
2782:
2778:
2774:
2770:
2762:
2759:
2756:
2749:
2746:
2743:
2736:
2733:
2728:
2722:
2718:
2714:
2713:
2705:
2702:
2697:
2693:
2689:
2685:
2682:(7): 564–71.
2681:
2677:
2670:
2668:
2664:
2659:
2655:
2651:
2644:
2641:
2636:
2632:
2629:(3): 389–93.
2628:
2624:
2617:
2614:
2608:
2603:
2599:
2595:
2591:
2584:
2581:
2576:
2570:
2566:
2565:
2557:
2554:
2548:
2545:
2540:
2536:
2532:
2528:
2523:
2518:
2514:
2510:
2506:
2499:
2497:
2495:
2493:
2491:
2487:
2481:
2479:
2477:
2475:
2473:
2471:
2469:
2467:
2465:
2463:
2461:
2459:
2457:
2453:
2447:
2442:
2438:
2434:
2430:
2422:
2419:
2414:
2410:
2405:
2400:
2395:
2390:
2386:
2382:
2378:
2371:
2368:
2361:
2358:
2353:
2349:
2344:
2339:
2335:
2331:
2327:
2323:
2319:
2315:
2311:
2304:
2301:
2296:
2292:
2287:
2282:
2278:
2274:
2270:
2263:
2260:
2255:
2251:
2247:
2243:
2239:
2235:
2231:
2227:
2220:
2217:
2212:
2208:
2203:
2198:
2194:
2190:
2186:
2182:
2179:(6): 576–83.
2178:
2174:
2170:
2163:
2161:
2157:
2151:
2148:
2142:
2139:
2134:
2130:
2126:
2122:
2118:
2114:
2110:
2106:
2099:
2096:
2091:
2087:
2082:
2077:
2073:
2069:
2065:
2058:
2055:
2050:
2044:
2039:
2038:
2028:
2026:
2024:
2022:
2020:
2018:
2016:
2014:
2012:
2010:
2008:
2006:
2004:
2000:
1994:
1991:
1985:
1982:
1970:
1966:
1960:
1957:
1952:
1948:
1943:
1938:
1934:
1930:
1926:
1919:
1916:
1911:
1907:
1902:
1897:
1893:
1889:
1885:
1878:
1876:
1874:
1872:
1870:
1868:
1866:
1864:
1862:
1860:
1856:
1851:
1847:
1842:
1837:
1833:
1829:
1826:(4): 605–14.
1825:
1821:
1817:
1810:
1808:
1806:
1802:
1797:
1793:
1789:
1785:
1782:(6): 565–71.
1781:
1777:
1770:
1767:
1762:
1758:
1754:
1750:
1746:
1742:
1738:
1734:
1727:
1725:
1723:
1721:
1719:
1717:
1715:
1713:
1711:
1709:
1707:
1703:
1698:
1694:
1689:
1684:
1680:
1676:
1672:
1665:
1663:
1659:
1654:
1650:
1645:
1640:
1636:
1632:
1628:
1624:
1620:
1616:
1612:
1608:
1604:
1597:
1594:
1589:
1585:
1580:
1575:
1570:
1565:
1561:
1557:
1553:
1546:
1544:
1542:
1540:
1538:
1536:
1534:
1532:
1530:
1528:
1526:
1524:
1522:
1520:
1518:
1516:
1514:
1512:
1510:
1508:
1506:
1504:
1502:
1500:
1498:
1496:
1494:
1492:
1490:
1488:
1486:
1484:
1482:
1480:
1476:
1469:
1467:
1464:
1456:
1454:
1448:
1446:
1444:
1440:
1436:
1432:
1428:
1423:
1416:
1414:
1407:
1405:
1403:
1402:Phenylephrine
1399:
1398:nitroprusside
1395:
1391:
1385:Heart failure
1384:
1382:
1380:
1372:
1370:
1368:
1360:
1358:
1354:
1352:
1346:
1338:
1336:
1331:
1323:
1318:
1314:
1310:
1306:
1303:
1299:
1295:
1291:
1287:
1283:
1279:
1276:
1272:
1268:
1264:
1263:beta-blockers
1260:
1259:
1258:
1255:
1253:
1249:
1245:
1241:
1234:
1232:
1229:
1225:
1221:
1213:
1211:
1204:
1202:
1200:
1196:
1188:
1186:
1183:
1181:
1177:
1176:heart failure
1173:
1166:
1165:
1159:
1157:
1152:
1147:
1145:
1136:
1133:
1130:
1129:
1125:
1122:
1119:
1118:
1114:
1111:
1108:
1107:
1103:
1100:
1097:
1096:
1090:
1085:
1082:
1081:
1078:
1074:
1068:
1066:
1063:
1056:
1054:
1052:
1048:
1044:
1039:
1037:
1033:
1029:
1025:
1017:
1015:
1013:
1009:
1005:
1001:
997:
993:
989:
985:
984:heart failure
981:
977:
973:
969:
965:
961:
957:
949:
944:
942:
938:
936:has developed
935:
931:
927:
923:
922:
921:
918:
916:
912:
911:meta-analysis
907:
905:
901:
897:
892:
890:
886:
882:
874:
872:
868:
864:
860:
856:
852:
847:
844:
836:
834:
832:
828:
824:
820:
819:
813:
805:
798:
790:
783:
781:
777:
773:
771:
767:
763:
759:
755:
754:regurgitation
750:
742:
737:
730:
728:
726:
722:
718:
717:Paget disease
714:
710:
709:Fabry disease
706:
702:
699:
695:
694:calcification
691:
687:
678:
671:
669:
667:
663:
659:
655:
651:
647:
643:
642:nitroglycerin
637:
635:
631:
624:Complications
623:
621:
619:
615:
611:
607:
603:
599:
595:
591:
583:
581:
579:
575:
571:
567:
560:
558:
556:
552:
547:
545:
541:
537:
533:
528:
525:
520:
518:
513:
509:
505:
500:
498:
491:
489:
487:
483:
482:
476:
471:
468:
464:
460:
455:
449:
447:
445:
442:with a light
441:
437:
436:Dresden china
433:
429:
425:
421:
417:
413:
408:
401:
399:
397:
393:
388:
386:
382:
381:phenylephrine
378:
377:Nitroprusside
374:
373:beta blockers
370:
369:nitroglycerin
366:
362:
358:
357:bioprosthetic
354:
350:
346:
341:
339:
335:
331:
327:
323:
319:
315:
311:
307:
306:calcification
303:
299:
294:
292:
288:
284:
280:
276:
272:
268:
264:
263:heart failure
260:
256:
252:
248:
244:
240:
236:
232:
223:
219:
215:
212:
210:
206:
203:
199:
196:
192:
189:
186:
184:
180:
176:
172:
168:
164:
161:
159:
155:
152:
148:
145:
141:
137:
133:
130:
129:Heart failure
127:
125:
124:Complications
121:
118:
114:
110:
106:
102:
100:
96:
93:
90:
88:
84:
80:
76:
72:
68:
64:
60:
55:
51:
46:
41:
33:
19:
5843:
5832:
5821:
5797:
5786:
5763:
5740:
5678:Dextrocardia
5493:Consequences
5232:Cardiomegaly
5206:ST elevation
5193:
5179:
5165:
5146:
5050:Ectopic beat
4998:fibrillation
4833:Bifascicular
4707:
4688:
4676:
4669:
4645:
4615:
4601:
4594:Endocarditis
4533:Hypertrophic
4467:Constrictive
4453:Pericarditis
4411:
4399:
4382:
4227:
4226:
4225:profile for
4222:
4183:
4179:
4153:
4114:
4110:
4104:
4070:(6): 135–9.
4067:
4063:
4053:
4020:
4016:
4010:
4001:
3977:(3): 630–4.
3974:
3970:
3960:
3936:(1): 11–19.
3933:
3929:
3919:
3895:
3888:
3879:
3870:
3835:
3831:
3821:
3786:
3782:
3772:
3737:
3733:
3723:
3688:
3684:
3647:(1): 55–61.
3644:
3640:
3629:
3598:
3594:
3546:
3542:
3509:
3484:
3480:
3469:
3460:
3454:
3445:
3410:
3406:
3396:
3361:
3357:
3347:
3312:
3308:
3297:
3254:
3250:
3240:
3215:1887/3279748
3195:
3191:
3180:
3137:
3133:
3122:
3112:
3098:cite journal
3063:
3059:
3049:
3041:the original
3036:
3027:
3018:
2975:
2971:
2960:
2917:
2913:
2902:
2859:
2855:
2848:
2823:
2819:
2809:
2776:
2772:
2761:
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2643:
2626:
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2547:
2512:
2508:
2436:
2432:
2421:
2384:
2380:
2370:
2360:
2317:
2313:
2303:
2276:
2272:
2262:
2232:(6): 476–8.
2229:
2225:
2219:
2176:
2172:
2150:
2141:
2108:
2104:
2098:
2071:
2067:
2057:
2036:
1993:
1984:
1972:. Retrieved
1968:
1959:
1932:
1928:
1918:
1891:
1887:
1823:
1819:
1779:
1775:
1769:
1736:
1732:
1678:
1674:
1610:
1606:
1596:
1559:
1555:
1460:
1452:
1424:
1420:
1417:Epidemiology
1411:
1388:
1376:
1364:
1355:
1348:
1333:
1282:hypertension
1256:
1252:rosuvastatin
1238:
1217:
1208:
1192:
1184:
1168:
1161:
1148:
1142:
1076:
1060:
1040:
1023:
1021:
953:
919:
908:
893:
875:
848:
840:
837:Auscultation
827:auscultation
816:
812:asymptomatic
809:
778:
774:
749:aortic valve
746:
703:
685:
683:
662:vasodilation
638:
634:endocarditis
627:
587:
564:
548:
529:
524:vasodilation
521:
501:
495:
479:ventricular
478:
472:
456:
453:
405:
389:
342:
334:heart murmur
316:and include
295:
290:
259:aortic valve
238:
234:
230:
229:
177:, being male
158:Risk factors
117:leg swelling
59:aortic valve
5823:MedlinePlus
5671:Uhl anomaly
5098:Romano–Ward
5065:Parasystole
4964:Ventricular
4916:Ventricular
4855:Tachycardia
4772:Heart block
4754:Bradycardia
4580:Endocardium
4543:Restrictive
4504:Myocarditis
4445:Pericardium
4148:‹ The
3880:Mayo Clinic
3740:(1): 71–7.
3481:Circulation
3134:Circulation
2820:Circulation
2068:Circulation
1675:Circulation
1275:hypotension
1195:chest X-ray
1189:Chest X-ray
1131:Very severe
1047:heart block
950:Blood tests
658:hydralazine
614:factor VIII
610:coagulation
555:heart block
371:, and some
253:(where the
135:Usual onset
5866:Categories
5845:Patient UK
5799:DiseasesDB
5683:Levocardia
4996:Flutter /
4959:Junctional
4894:Junctional
4887:Multifocal
4860:paroxysmal
4776:Sinoatrial
4745:arrhythmia
4740:Conduction
4496:Myocardium
4023:(1): 1–7.
2978:: 101875.
2105:The Lancet
1470:References
1461:People on
1235:Medication
1214:Management
1151:calculated
1115:1.0 - 1.5
996:troponin T
906:, emerge.
747:The human
540:myocardium
353:mechanical
279:lying down
5834:eMedicine
5255:Pulmonary
5038:Pacemaker
4709:pulmonary
4690:tricuspid
4526:Alcoholic
4045:205746869
3862:231680789
3813:229175207
3691:: i5065.
3601:: i5085.
3549:: i5130.
3501:0009-7322
3331:0195-668X
3289:201846410
3273:1936-878X
3224:1010-7940
3172:229316533
3156:0009-7322
3117:21321159.
2992:2589-5370
2934:2380-6583
2886:0735-1097
2840:0009-7322
2793:0195-668X
2334:1340-3478
1761:205041976
1635:1476-1122
1408:Prognosis
1313:diuretics
1228:inpatient
1137:< 0.6
1126:< 1.0
976:NT-proBNP
926:apex beat
806:Palpation
784:Diagnosis
725:infection
654:terazosin
243:narrowing
241:) is the
221:Frequency
209:Prognosis
194:Treatment
87:Specialty
5628:stenosis
5616:bicuspid
5606:stenosis
5578:stenosis
5546:stenosis
5121:Asystole
5021:Familial
4715:stenosis
4696:stenosis
4677:stenosis
4658:stenosis
4653:prolapse
4375:Sequelae
4278:Ischemia
4202:29054308
4150:template
4131:22497825
4096:21160731
4037:20678125
3952:21178291
3911:Archived
3854:33478630
3805:33314301
3764:25694981
3715:27683072
3663:25442986
3621:Archived
3617:27680583
3573:27683246
3437:17276178
3388:24445487
3339:34453165
3281:31488252
3232:34453161
3164:33332150
3090:31088012
3010:36915288
3001:10006443
2952:35171199
2894:24657652
2801:34453165
2635:20583404
2531:22129836
2413:38424219
2404:10904700
2387:(1): 6.
2352:30867356
2295:21484065
2254:23695741
2211:23603848
2133:23132191
2090:11956110
1951:10193710
1910:24174503
1850:22896576
1796:24838132
1753:24104373
1697:18765387
1653:23603848
1588:25368539
1457:Research
1271:Nitrates
1109:Moderate
1104:>1.5
1049:such as
1024:specific
851:systolic
758:stenotic
646:nitrates
612:factor (
467:ischemia
407:Symptoms
330:diabetes
283:at night
175:diabetes
99:Symptoms
5839:med/157
5793:D001024
5568:atresia
5556:absence
4521:Dilated
4463:Chronic
4271:(heart)
4219:Scholia
4152:below (
4087:2999052
3993:9060903
3755:4311159
3706:5040922
3564:5040923
3428:3951859
3379:4263317
3081:6750174
2943:8851368
2696:9032164
2539:7629351
2343:6456452
2234:Bibcode
2202:5833942
2181:Bibcode
2125:6150181
1974:30 June
1841:3427002
1644:5833942
1615:Bibcode
1579:4213201
1449:History
1309:digoxin
1265:and/or
1244:statins
1199:chronic
1112:25 - 40
932:of the
831:carotid
600:of the
596:due to
497:Syncope
492:Syncope
416:anginal
394:in the
347:, with
318:smoking
249:of the
163:Smoking
138:Gradual
5828:000178
5406:dextro
5201:J wave
4954:Atrial
4882:Atrial
4671:aortic
4647:mitral
4639:Valves
4585:valves
4437:Layers
4306:(SCAD)
4221:has a
4200:
4169:Curlie
4155:Curlie
4129:
4094:
4084:
4043:
4035:
3991:
3950:
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3852:
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1576:
1441:, and
1134:>70
1123:>40
1120:Severe
1101:<25
1088:(mmHg)
1083:Degree
855:murmur
723:, and
672:Causes
576:) and
450:Angina
440:pallor
300:, and
143:Causes
69:. The
5782:746.3
5778:396.0
5774:395.0
5759:Q23.0
5755:I06.0
5751:I35.0
5661:right
5648:Other
5534:Right
5288:Other
5272:Right
5250:Right
4864:sinus
4813:Right
4563:Viral
4458:Acute
4412:weeks
4383:hours
4295:(CAD)
4223:topic
4041:S2CID
3858:S2CID
3809:S2CID
3285:S2CID
3168:S2CID
2654:Heart
2535:S2CID
2439:(3).
2129:S2CID
1757:S2CID
1093:(cm)
1010:, or
602:colon
517:brain
444:flush
430:, or
269:, or
255:aorta
251:heart
67:aorta
5788:MeSH
5769:9-CM
5666:left
5594:Left
5411:levo
5267:Left
5245:Left
4862:and
4818:Left
4400:days
4198:PMID
4127:PMID
4092:PMID
4033:PMID
3989:PMID
3948:PMID
3901:ISBN
3850:PMID
3801:PMID
3760:PMID
3711:PMID
3659:PMID
3613:PMID
3569:PMID
3518:ISBN
3497:ISSN
3433:PMID
3384:PMID
3335:PMID
3327:ISSN
3277:PMID
3269:ISSN
3228:PMID
3220:ISSN
3160:PMID
3152:ISSN
3104:link
3086:PMID
3006:PMID
2988:ISSN
2948:PMID
2930:ISSN
2890:PMID
2882:ISSN
2836:ISSN
2797:PMID
2789:ISSN
2721:ISBN
2692:PMID
2676:JAMA
2631:PMID
2569:ISBN
2527:PMID
2409:PMID
2348:PMID
2330:ISSN
2291:PMID
2250:PMID
2207:PMID
2121:PMID
2086:PMID
2043:ISBN
1976:2021
1947:PMID
1906:PMID
1846:PMID
1792:PMID
1749:PMID
1733:JAMA
1693:PMID
1649:PMID
1631:ISSN
1584:PMID
1311:and
1280:Any
1164:mmHg
1098:Mild
825:(on
768:and
5804:844
5765:ICD
5742:ICD
4188:doi
4167:at
4119:doi
4082:PMC
4072:doi
4025:doi
3979:doi
3938:doi
3840:doi
3791:doi
3750:PMC
3742:doi
3701:PMC
3693:doi
3689:354
3685:BMJ
3649:doi
3603:doi
3599:354
3595:BMJ
3559:PMC
3551:doi
3547:354
3543:BMJ
3489:doi
3485:134
3423:PMC
3415:doi
3374:PMC
3366:doi
3317:doi
3259:doi
3210:hdl
3200:doi
3142:doi
3138:143
3076:PMC
3068:doi
2996:PMC
2980:doi
2938:PMC
2922:doi
2872:hdl
2864:doi
2828:doi
2824:109
2781:doi
2684:doi
2680:277
2602:doi
2517:doi
2513:121
2441:doi
2437:133
2399:PMC
2389:doi
2338:PMC
2322:doi
2281:doi
2242:doi
2197:PMC
2189:doi
2113:doi
2109:324
2076:doi
2072:105
1937:doi
1896:doi
1892:113
1836:PMC
1828:doi
1784:doi
1741:doi
1737:310
1683:doi
1679:118
1639:PMC
1623:doi
1574:PMC
1564:doi
1292:or
1014:).
960:BNP
588:In
486:EKG
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379:or
355:or
239:AoS
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