Predicting Outcome in Patients With Asymptomatic

Although the annual risk of cardiovascular mortality hasbeen well described for individuals with symptomatic aortic stenosis, the morbidity and mortality for those with asymptomatic severe aortic stenosis is not as well known. Currently the American Heart Association/American College of Cardiology recommends a “watchful waiting ” strategy for those with asymptomatic aortic stenosis.1 This involves clinical examinations every 6 to 12 months and annual echocardiograms; however, it is unclear what to do with these data in the patient who remains asymptomatic. The asymp-tomatic patient is generally not referred for aortic valve replacement surgery until the development of symptoms (unless concurrent coronary artery bypass grafting is required or if systolic dysfunction develops). Article see p 69 Approximately 30 % of asymptomatic patients will develo