Aortic stenosis electrocardiogram
Aortic Stenosis Microchapters
Transcatheter Aortic Valve Replacement (TAVR)
Aortic stenosis electrocardiogram On the Web
American Roentgen Ray Society Images of Aortic stenosis electrocardiogram
Editor-In-Chief: C. Michael Gibson, M.S., M.D. ; Associate Editor(s)-In-Chief: Mohammed A. Sbeih, M.D. ; Lakshmi Gopalakrishnan, M.B.B.S. ; Usama Talib, BSc, MD  Assistant Editor-In-Chief: Kristin Feeney, B.S. 
- Although there are no specific findings on the EKG, the presence of left ventricular hypertrophy (LVH) secondary to chronic pressure overload of the left ventricle due to aortic stenosis is commonly observed.
- Progressive calcification of the aortic valve may extend beyond the valve and may result in conduction abnormalities of the heart including heart block.
- Progressive concentric hypertrophy of the left ventricular wall may lead to larger QRS complexes, especially observed in leads V1-V6. The S wave in V1 is deep, the R wave in V4 is high. Often some ST depression can be seen in leads V5-V6, which is in this setting is called a left ventricular strain pattern.
Criteria for LVH
- Sokolow-Lyon criteria:
- R in V5 or V6 + S in V1 > 35 mm
- Other criteria:
- R > 26 mm in V5 or V6
- R > 20 mm in I, II or III
- R > 12 mm in aVL (in the absence of left anterior fascicular block)
- Cornell criteria has different values in men and women:
- R in aVL and S in V3 > 28 mm in men
- R in aVL and S in V3 > 20 mm in women
- In the Romhilt-Estes Score,:
Examples of EKG Findings in patients with AS
Shown below is an electrocardiogram depicting left ventricular hypertrophy.
Shown below is an EKG depicting left ventricular hypertrophy and subendocardial ischemia.
Shown below is an EKG depicting left ventricular hypertrophy and left ventricular strain pattern.
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org
2008 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease - Evaluation of Asymptomatic Adolescents or Young Adults With Aortic Stenosis (DO NOT EDIT)
|"1. An ECG is recommended yearly in the asymptomatic adolescent or young adult with AS who has a Doppler mean gradient greater than 30 mm Hg or a peak velocity greater than 3.5 m per second (peak gradient greater than 50 mm Hg) and every 2 years if the echocardiographic Doppler mean gradient is less than or equal to 30 mm Hg or the peak velocity is less than or equal to 3.5 m per second (peak gradient less than or equal to 50 mm Hg). (Level of Evidence: C)"|
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- Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter