What are the signs and symptoms of aortic stenosis (AS)?

Updated: May 07, 2019
  • Author: Xiushui (Mike) Ren, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Other symptoms of aortic stenosis include the following:

  • Pulsus alternans: Can occur in the presence of left ventricular systolic dysfunction

  • Hyperdynamic left ventricle: Unusual; suggests concomitant aortic regurgitation or mitral regurgitation

  • Soft or normal S1

  • Diminished or absent A2: The presence of a normal or accentuated A2 speaks against the existence of severe aortic stenosis

  • Paradoxical splitting of the S2: Resulting from late closure of the aortic valve with delayed A2

  • Accentuated P2: In the presence of secondary pulmonary hypertension

  • Ejection click: Common in children and young adults with congenital aortic stenosis and mobile valve leaflets

  • Prominent S4: Resulting from forceful atrial contraction into a hypertrophied left ventricle

  • Systolic murmur: The classic crescendo-decrescendo systolic murmur of aortic stenosis begins shortly after the first heart sound; the intensity increases toward mid systole and then decreases, with the murmur ending just before the second heart sound

See Presentation for more detail.

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