REVIEW

Aortic sclerosis: not an innocent murmur but a marker of increased cardiovascular risk

A K Nightingale, J D Horowitz

Department of Cardiology, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, Australia

Correspondence to:
Dr Angus Nightingale
Department of Cardiology, The Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, SA 5011, Australia; drangus{at}doctors.org.uk

The detection of an ejection systolic murmur in the aortic valve region often corresponds to a diagnosis of aortic sclerosis or minor disruption of the aortic valve with associated turbulence but minimal obstruction. Aortic sclerosis has two important clinical implications. Firstly, aortic sclerosis is an antecedent to clinically significant aortic valve obstruction and, secondly, it acts as a marker of increased risk of cardiovascular events. This article reviews the evidence that aortic sclerosis is a useful adjunctive tool in cardiovascular risk stratification and that its progression to haemodynamically significant aortic stenosis is a potential focus for individual monitoring and for interventional studies.

Abbreviations: ACE, angiotensin converting enzyme; ARIC, atherosclerosis risk in communities; CT, computed tomography; LIFE, losartan intervention for endpoint reduction in hypertension; SPARC, stroke prevention: assessment of risk in a community

Keywords: aortic valve; aortic stenosis; aortic sclerosis; cardiovascular risk

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