Aortic Sclerosis Monitoring and Management

Disease Characteristics

• Aortic sclerosis is characterized by focal areas of increased echogenicity and thickening of valve leaflets, with no restriction of valve motion, and peak velocity less than 2.5 m/s, and no significant hemodynamic consequences 2, 3, 4
• The American College of Cardiology describes aortic sclerosis as an early stage in the spectrum of calcific aortic valve disease 2

Monitoring and Follow-up

• The American Heart Association recommends echocardiography every 3-5 years for patients with aortic sclerosis in the absence of symptoms or clinical changes 1
• For patients with mild aortic stenosis, the American College of Cardiology recommends echocardiography every 3-5 years 1
• More frequent echocardiographic assessment is recommended if new or changing cardiac symptoms develop, or if there is evidence of disease progression on ECG 1, 2
• The European Society of Cardiology suggests comprehensive echocardiographic assessment to confirm aortic sclerosis, and to document baseline valve morphology, calcification, and hemodynamics 3, 6

Risk Stratification and Special Considerations

• Patients with bicuspid aortic valve and aortic sclerosis are at higher risk of rapid progression, and annual echocardiography is recommended 5
• Hypertension may alter measurements and should be recorded during each examination, and inadequate Doppler alignment can underestimate velocity and severity 1, 4