Stage | Definition | Valve anatomy | Valve hemodynamics | Hemodynamic consequences | Symptoms |
A | At risk of AS |
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B | Progressive AS |
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C: Asymptomatic severe AS | |||||
C1 | Asymptomatic severe AS |
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C2 | Asymptomatic severe AS with LV dysfunction |
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D: Symptomatic severe AS | |||||
D1 | Symptomatic severe high-gradient AS |
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D2 | Symptomatic severe low-flow/low-gradient AS with reduced LVEF |
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D3 | Symptomatic severe low-gradient AS with normal LVEF or paradoxical low-flow severe AS |
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Reproduced from: Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63:e57. Table used with the permission of Elsevier Inc. All rights reserved.
Information still current as of 2021, as found in: Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021;143:e72.