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Investigations

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  • Electrocardiography - this usually shows left ventricular hypertrophy.

  • chest X-ray
    • lateral film - calcification of the valve may be seen.
    • PA film - the left ventricle is normal sized until there is left ventricular failure (or coincident regurgitation). There may be poststenotic dilatation of the ascending aorta.

  • echocardiography and Doppler scanning - there may be left ventricular thickening of the free wall and septum (>1cm). Dilation of the left ventricle occurs if there is associated aortic regurgitation or failure. Doppler ultrasound may be used to assess the pressure gradients.

  • cardiac catheterisation and angiocardiography - A Gorlin valve area of 0.5 cm sq. is indicative of severe aortic stenosis.

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