Aortic Stenosis – 5 Key Echo Parameters
Mini-Lesson to Spice Up Your Inbox
Aortic stenosis (AS) is a progressive narrowing of the aortic valve that increases resistance to blood flow from the left ventricle to the aorta. Over time, this increased workload leads to left ventricular hypertrophy, and if untreated, can progress to heart failure. Think of it like trying to force water through a kinked garden hose—the tighter the kink (or the valve), the harder the pump (your heart) has to work.
The most common causes of AS include:
Age-related calcific degeneration
Congenital bicuspid aortic valve
Rheumatic heart disease
Radiation-induced and infective endocarditis are less common origins
🧠 How Do We Grade Aortic Stenosis?
Echocardiography is the go-to tool for diagnosing and tracking AS. But it's not based on just one number. We rely on a combination of five key parameters to get an accurate picture:
Peak Aortic Velocity (Vmax)
Measures how fast blood is jetting through the narrowed valve with continuous wave Doppler or the blind pedoff probe.Mean Pressure Gradient (Mean PG)
Reflects the average pressure difference across the valve during systole.Aortic Valve Area (AVA)
A calculated measurement of the valve’s opening. Smaller areas indicate more severe stenosis.Indexed Aortic Valve Area (AVAi)
AVA adjusted for body surface area. Helps assess severity more accurately in patients with varying body habitus.Velocity Ratio (Dimensionless Index)
A ratio of LVOT velocity to aortic jet velocity. Less than 0.25 typically suggests severe AS.
🎓 Want to go deeper into grading AS with a case example and walkthrough?
Check out our full lesson on Aortic Stenosis – where we break it down with flow charts and expert tips.
📚 Preparing for Your Echo Boards?
When our team was studying for board exams, we struggled to find high-quality practice tests. The few that existed were built by big companies — not echo specialists — and often missed the nuance and clinical relevance we needed.
That’s why we built our own.
Over the past year, we’ve reinvested in our platform to create a comprehensive Echo Board Prep program — crafted by echo fanatics (that’s us). With 1,200+ board-style questions organized into beginner, intermediate, expert, and sonographic physics sections, it’s designed to help you build real exam-day confidence.
📝 If you’re preparing for your boards, this is the resource we wish we had.
