Aortic Stenosis Review: Pathophysiology, Clinical Symptoms, and Key Diagnostic Signs
Authors
Baiq Syarifaturrayyan Maharani , Nanggi Qoriatul Febriana , Padmi Kartika Sari , Baiq Zaskia Maudina , Baiq Sheila Oktalia HakimDOI:
10.29303/jbt.v25i4.10105Published:
2025-10-03Issue:
Vol. 25 No. 4 (2025): in ProgressKeywords:
Aortic stenosis, clinical symptoms, diagnostic signs, pathophysiology.Articles
Downloads
How to Cite
Downloads
Abstract
Aortic stenosis is among the most common valvular heart diseases, particularly in the elderly, and remains a major cause of morbidity and mortality. It is characterized by narrowing of the aortic valve, leading to increased afterload, compensatory left ventricular hypertrophy, and eventual heart failure or sudden death. To summarize updated evidence on the pathophysiology, clinical manifestations, and diagnostic signs of aortic stenosis. A literature review was conducted through systematic searches of PubMed, ScienceDirect, and Google Scholar, prioritizing publications from the last ten years. Articles on anatomy, physiology, pathophysiology, clinical features, diagnostic findings, and disease progression were critically analyzed. Aortic stenosis develops through degenerative calcification, rheumatic autoimmune inflammation, or congenital malformation. Disease progression leads to elevated transvalvular gradient, reduced stroke volume, and left ventricular hypertrophy. Typical symptoms include angina, syncope, and heart failure. Key diagnostic signs are a crescendo–decrescendo systolic ejection murmur radiating to the carotid arteries and the Gallavardin phenomenon. Aortic stenosis is a progressive valvular disease with complex pathophysiological mechanisms. Comprehensive understanding of its biological processes, clinical manifestations, and diagnostic signs is essential to support early detection and timely management. Such efforts may reduce morbidity and mortality while paving the way for innovative therapeutic strategies in the future.
References
Aikawa, E. (2024). Challenges and opportunities in valvular heart disease. Arteriosclerosis, Thrombosis, and Vascular Biology, 44(4), 345–356. https://doi.org/10.1161/ATVBAHA.123.319563
Ambrosy, A. P., Go, A. S., Leong, T. K., Garcia, E. A., Chang, A. J., Slade, J. J., McNulty, E. J., Mishell, J. M., Rassi, A. N., Ku, I. A., Lange, D. C., & Philip, F. (2023). Temporal trends in the prevalence and severity of aortic stenosis within a contemporary and diverse community-based cohort. International Journal of Cardiology, 384, 107–111. https://doi.org/10.1016/j.ijcard.2023.04.047
American Heart Association. (2020). Cardiovascular condition: What’s aortic stenosis? https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/whats-aortic-stenosis
Courtney, W. A., Schultz, C. J., & Hillis, G. S. (2023). Aortic valve calcification and outcomes in severe aortic stenosis. Heart, 109(19), 1426–1428. https://doi.org/10.1136/heartjnl-2023-322771
David, T., Lafreniere-Roula, M., David, C., & Issa, H. (2021). Outcomes of combined aortic and mitral valve surgery. Journal of Thoracic and Cardiovascular Surgery, 162(6), 1861–1869. https://doi.org/10.1016/j.jtcvs.2020.08.107
Dehghani, P., Singh, J., Singer, Z., Booker, J., Lavoie, A., & Zimmermann, R. (2023). Catheter-induced postextrasystolic potentiation in the assessment of severity of low-gradient aortic valve stenosis. Circulation: Cardiovascular Interventions, 16(10), e012892. https://doi.org/10.1161/circinterventions.123.012892
Di Costanzo, A., Indolfi, C., Franzone, A., Esposito, G., & Spaccarotella, C. A. M. (2023). Lp(a) in the pathogenesis of aortic stenosis and approach to therapy with antisense oligonucleotides or short interfering RNA. International Journal of Molecular Sciences, 24(19), 14939. https://doi.org/10.3390/ijms241914939
Fukumoto, Y. (2023). Safe aortic valve intervention to very severe aortic stenosis. American Journal of Cardiology, 195, 495–496. https://doi.org/10.1016/j.amjcard.2023.06.011
Gofur, N. R. (2021). Sign and treatment of aortic stenosis: A review article. Acta Scientific Clinical Case Reports, 2(2), 22–28. https://actascientific.com/ASCR/pdf/ASCR-02-0107.pdf
Grave, C., Dupont, A., & Bernard, J. (2024). Epidemiology of valvular heart disease in France: Insights from a national registry. Archives of Cardiovascular Diseases, 117(9), 633–642. https://doi.org/10.1016/j.acvd.2024.05.004
Halapas, A., & Giannakoulas, G. (2025). Aortic stenosis prevention: Is a new cardiovascular approach possible? Journal of Clinical Medicine, 14(3), 903. https://doi.org/10.3390/jcm14030903
Hamana, T. (2025). Age differences in aortic stenosis. Journal of Cardiology, 85(2), 101–108. https://doi.org/10.1016/j.jjcc.2024.10.015
Ito, S., & Oh, J. K. (2022). Aortic stenosis: New insights in diagnosis, treatment, and prevention. Korean Circulation Journal, 52(10), 721–736. https://doi.org/10.4070/kcj.2022.0234
Klabunde, R. (2021). Cardiovascular physiology concepts (3rd ed.). Wolters Kluwer. ISBN: 9781975106947
Le Nezet, E., Martin, C., & Delhaye, C. (2024). Molecular features of calcific aortic stenosis in female patients. JACC: Advances, 3(5), 125–136. https://doi.org/10.1016/j.jacadv.2024.07.003
Lüscher, T. (2022). Manual of cardiovascular medicine (3rd ed.). Oxford University Press. ISBN: 9780198856266
Melgar, T., & Doherty, E. (2020). Cardiology: A review. Novus International Journal of Cardiology, 12(4), 313–337. https://novusscientia.org/journals/index.php/nsijc/article/view/223
Netter, F. (2020). Atlas anatomi manusia (7th ed.). Elsevier. ISBN: 9780323393225
Panduranga, A. (2023). A rare case: Congestive heart failure due to isolated aortic valve disease in a middle-aged man secondary to rheumatic fever. Cureus, 15(5), e38627. https://doi.org/10.7759/cureus.38627
Rana, M. (2022). Aortic valve stenosis: Diagnostic approaches and recommendations of the 2021 ESC/EACTS guidelines for the management of valvular heart disease – A review of the literature. Cardiology and Cardiovascular Medicine, 6(3), 123–132. https://doi.org/10.26502/fccm.92920347
Rayner, C., & Adams, H. (2023). Aortic stenosis and transcatheter aortic valve implantation in the elderly. Australian Journal of General Practice, 52(7), 458–463. https://doi.org/10.31128/AJGP-09-22-6577
Shah, S. M., Shah, J., Lakey, S. M., Garg, P., & Ripley, D. P. (2023). Pathophysiology, emerging techniques for the assessment and novel treatment of aortic stenosis. Open Heart, 10(1), e002244. https://doi.org/10.1136/openhrt-2022-002244
Small, A. M., & Singh, R. K. (2024). Unraveling the mechanisms of valvular heart disease: Pathophysiology and clinical implications. Circulation, 149(12), 876–889. https://doi.org/10.1161/CIR.0000000000001254
Vavilis, G., Ohlsson, A., & Lund, L. H. (2022). Epidemiology of aortic stenosis and aortic valve replacement: A population-based study. American Journal of Cardiology, 170, 123–131. https://doi.org/10.1016/j.amjcard.2021.09.001
Yasuhara, J., & Tanaka, Y. (2023). Congenital aortic valve stenosis: From pathophysiology to management. Frontiers in Cardiovascular Medicine, 10, 1142707. https://doi.org/10.3389/fcvm.2023.1142707
License
Copyright (c) 2025 Baiq Syarifaturrayyan Maharani, Nanggi Qoriatul Febriana, Padmi Kartika Sari, Baiq Zaskia Maudina, Baiq Sheila Oktalia Hakim

This work is licensed under a Creative Commons Attribution 4.0 International License.
Jurnal Biologi Tropis is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of the received article shall be assigned to the author as the owner of the paper. The intended copyright includes the right to publish the article in various forms (including reprints). The journal maintains the publishing rights to the published articles.
Authors are permitted to disseminate published articles by sharing the link/DOI of the article at the journal. Authors are allowed to use their articles for any legal purposes deemed necessary without written permission from the journal with an acknowledgment of initial publication to this journal.