Which of the following is/are indications for aortic valve replacement for aortic stenosis?

A. Syncope.

B. Congestive heart failure.

C. Angina.

DISCUSSION: With progressive narrowing of the aortic valve area from the normal 3 to 4 sq. cm. to 1 sq. cm., patients become symptomatic. The classic symptoms produced by aortic stenosis are syncope, congestive heart failure, and angina. Once symptoms occur, life expectancy is limited to 2 to 5 years. Therefore, symptomatic aortic stenosis is an indication for aortic valve replacement. The risk of death with asymptomatic aortic stenosis is quite low, and aortic valve replacement is not indicated for asymptomatic patients with a transvalvar gradient less than 50 mm. Hg.