Aortic Stenosis

Abstract
A 60-year-old man is evaluated for a heart murmur. He jogs regularly and has no cardiac symptoms. Examination reveals a delayed carotid upstroke and a grade 3/6 late-peaking systolic ejection murmur. Echocardiography shows normal systolic function and a heavily calcified aortic valve, with a peak Doppler transvalvular gradient of 64 mm Hg and a calculated valve area of 0.7 cm2.