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I thoroughly enjoyed the excellent editorial on aortic stenosis by Alpert.¹ His masterly discussion of the relationship between aortic valvular sclerosis and aortic valvular stenosis, from both the prognostic and therapeutic points of view, is extremely important and most timely in view of the recent evidence that treatment of hypercholesterolemia may retard the progression of atherosclerotic aortic valvular sclerosis into stenosis.²

I would like to make some comments from the diagnostic point of view, namely, the differential diagnosis between aortic valvular stenosis and aortic valvular sclerosis. Because people are living longer nowadays and an aortic ejection systolic murmur is a common physical finding in many elderly individuals, it is important to know if the aortic valve is stenotic or merely sclerotic from the characteristics of the murmur. Furthermore, when the high frequency component selectively radiates to the apex and when it is not well heard at the base, especially in . . . [Full Text of this Article]

Tsung O. Cheng, MD
Washington, DC

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RELATED ARTICLE

Aortic Stenosis: A New Face for an Old Disease
Joseph S. Alpert
Arch Intern Med. 2003;163(15):1769-1770.
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