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Aortic sclerosis: not an innocent murmur but a marker of increased cardiovascular risk
  1. A K Nightingale,
  2. J D Horowitz
  1. Department of Cardiology, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, Australia
  1. Correspondence to:
    Dr Angus Nightingale
    Department of Cardiology, The Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, SA 5011, Australia;


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.

  • 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
  • aortic valve
  • aortic stenosis
  • aortic sclerosis
  • cardiovascular risk

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  • Both authors fulfil the criteria for authorship and have no competing interests to declare.