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Aortic Stenosis: A Clinical Study of Aortic Stenosis, Isolated or Combined With Aortic Insufficiency, With Special Reference to Haemodynamic and Angiocardiographic Observations

William H. Wehrmacher, MD
JAMA. 1965;191(12):1036. doi:10.1001/jama.1965.03080120070038.
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If we heed the correlations Cullhed has shown between quantitative disturbances in blood flow and clinical findings, the diagnosis and adjudication of aortic valvular disease will be greatly facilitated.

Sixty-seven patients referred for preoperative evaluation were studied at the University Hospital in Upsala, Sweden, between 1958 and 1963 to determine the hemodynamic, clinical, and angiocardiographic changes occurring in acquired aortic stenosis. The present volume reports the findings.

Dyspnea on effort was a sensitive but not a specific sign, while pain in the chest and dizziness on effort were less sensitive but more specific signs of the severity of aortic stenosis. The hypertrophic thrust of the left ventricle, absent or diminished second heart sound, and a grade 4-6 basal systolic murmur of long duration with maximum intensity reached late in systole, were correlated with the higher pressure gradients across the aortic valve. Radiographically demonstrable calcification of the aortic valve in patients


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