Title: Contrast echocardiographic assessment of the severity of aortic stenosis in a patient with nondiagnostic baseline Doppler-echocardiographic study
- Michał Plewka, Maria Krzemińska-Pakuła, Jarosław Drożdż, Jarosław D. Kasprzak
- Case Reports
- Polish Journal of Cardiology
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- Final page:
- aortic stenosis, Doppler echocardiography, contrast echocardiography, Levovist
Two-dimensional Doppler echocardiography is an established clinical tool for the assessment of valvular heart disease. However, in case of patients with aortic stenosis and bad acoustic window, transaortic gradient may be underestimated. We present a case of 61-year woman with suspected aortic stenosis and non-diagnostic transthoracic Doppler-echocardiography. There was a discrepancy between the clinical presentation as well as the morphology of the aortic valve (fibrosis and calcifications) and a relatively low gradient in continuous wave Doppler examination. A contrast echocardiographic study using Levovist (Schering AG, Berlin) was performed. The aortic gradient in standard study was severely underestimated as compared with contrast Doppler and transesophageal echocardiography: 49 mm Hg and 125 mm Hg, respectively. The patient was scheduled for aortic valve replacement (CarboMedics) and operated on successfully.