What is the most appropriate management for symptomatic aortic stenosis?

Symptomatic aortic stenosis is a serious condition characterized by the narrowing of the aortic valve, which impairs blood flow from the heart to the rest of the body. The presence of symptoms such as exertional dyspnea, angina, or syncope indicates that the condition has progressed and is likely impacting the patient's quality of life and overall health.

The most appropriate management for individuals with symptomatic aortic stenosis is to refer them for valve replacement. Surgical intervention, either through traditional open-heart surgery or transcatheter aortic valve replacement (TAVR), is necessary to alleviate symptoms and prevent complications such as heart failure or sudden cardiac death. Valve replacement addresses the underlying mechanical issue and significantly improves survival rates and quality of life.

In contrast, starting beta-blocker therapy or calcium channel blockers is generally not recommended as a primary treatment for symptomatic aortic stenosis. These medications do not resolve the obstruction created by the stenotic valve and can potentially worsen symptoms in this context. Monitoring echocardiograms annually may be appropriate for asymptomatic patients or those with mild stenosis, but it is not sufficient for those already experiencing symptoms. Therefore, intervention through valve replacement is essential for patients with symptomatic aortic stenosis.