[Calcified aortic stenosis. Semiology and non-invasive diagnostic aspects in the elderly]. / Estenosis aórtica calcificada. Semiología y aspectos diagnósticos no invasivos en el anciano.

Aortic stenosis (AoS) is a relatively common condition in elderly patients. It has different clinical manifestations from AoS seen in young individuals. We examined the manifestations of AoS in the elderly with emphasis on the findings that noninvasive techniques provide. Our study involved a retrospective analysis of 23 patients over 60 years old with diagnosis of calcified AoS established by hemodynamic studies. Calcification of the aortic valve on chest X-ray, left ventricular ejection time (LVET), from of the carotid pulse and thickness of ventricular walls by echocardiography proved to be useful variables for qualitative evaluation. The presence of syncope, murmur in mid-and end-systole and paradoxical splitting of the second sound as well as a LVET of more than 110% indicate a transaortic gradient greater than 50 mmHg. We conclude that evaluation by cardiac catheterization is required only in selected cases.

[Maximum flow velocity in the normally functioning Björk-Shiley mitral prosthesis]. / Velocidad máxima del flujo en la prótesis mitral de Bjork-Shiley normofuncionante.

The heart valve prosthesis, even with normal function produce a functional obstruction to the blood flow increasing its maximal velocity. With pulsed wave Doppler technique we measured the maximal velocity in 12 patients with normally functioning Bjork-Shiley mitral prosthesis, (group I), comparing the results with those obtained in 12 healthy persons (group II). The maximal velocity of group I was significantly higher than that of group II (p less than 0.001) and higher than the values so far reported in the literature. In 5 patients of group I the maximal velocity was above 2.6 m/sec, which is the upper limit that our Doppler unit is able to register. We conclude that the maximal velocity of blood flow through some Bjork-Shiley mitral valves with normal function may be higher than those reported in the literature. Therefore the pulsed wave Doppler technique has limited application in the evaluation of transprothetic flow.