How does the AHA/ACC classify the stages of aortic stenosis?

Updated: May 07, 2019
  • Author: Xiushui (Mike) Ren, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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The 2014 AHA/ACC guidelines classify progression of valvular aortic stenosis (AS) into four stages (A to D), as summarized below. [6] :

Stage A: At risk of AS

Stage B: Progressive AS 

Stage C: Asymptomatic severe AS, as follows:

  • C1: Asymptomatic severe AS
  • C2: Asymptomatic severe AS with LV dysfunction

Stage D: Symptomatic severe AS, as follows

  • D1 Symptomatic severe high-gradient AS
  • D2 Symptomatic severe low flow/low gradient AS with reduced left ventricular ejection fraction (LVEF)
  • D3 Symptomatic severe low gradient AS with normal LVEF or paradoxical low flow severe AS

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