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  • true congenital aortic stenosis:
    • the stenosis is manifest from birth
    • there is a small hole in a domed valve

  • calcification of congenitally deformed valve:
    • premature calcification of a bicuspid aortic valve is the commonest cause of aortic stenosis
    • it is usually asymptomatic during the first three decades of life during which it may be diagnosed after hearing an aortic ejection sound and a soft ejection murmur
    • symptoms may begin in fourth decade of life
    • rarely, the congenital deformity may be a unicuspid valve

  • senile aortic stenosis:
    • aortic cusp sclerosis occurs when calcium deposition spreads form the hinge areas of three otherwise normal cusps causing stenosis
    • patients are usually elderly - in their 70's

  • rheumatic fusion of the valve commissures and thickening of cusps:
    • usually accompanied by aortic regurgitation and mitral valve involvement
    • it accounts for about 10% of acquired aortic stenosis

Last reviewed 01/2018