Aortic Stenosis

Aortic Stenosis Severity

Interpret AS severity and phenotype from echo data. Identify concordant severe AS, discordant patterns, and low-flow low-gradient subtypes.

Primary standard:ACC/AHA VHD 2020

Echo measurements

Enter available values — partial input is supported.

Primary parameters

Severe ≥ 4.0 m/s

Severe ≥ 40 mmHg

Severe < 1.0 cm²

Additional parameters

< 50% = reduced EF

< 35 mL/m² = low flow

Severe < 0.25

Measurement context

Valve calcification

Doppler acquisition quality

Assessment

Enter at least one velocity, gradient, or AVA measurement to see the assessment.

Why one number is not enough

AVA and gradient can disagree

AVA is flow-dependent. In low-flow states, gradient falls even when the valve is severely stenosed. Neither parameter alone is sufficient — concordance is what matters.

Low flow changes everything

Low stroke volume reduces gradient independently of valve severity. SVI < 35 mL/m² signals that the gradient may be underestimating the true stenosis.

High flow inflates gradient

Anemia, aortic regurgitation, or high cardiac output states can push velocity and gradient above thresholds even with a non-severely stenosed valve. Always consider flow context.

Learn the echo reasoning pathway

Review how valve severity, LV function, filling pressures, and intraoperative TEE findings connect in perioperative echo assessment.

Open Echo Education