Would you favor CT AV calcium score or dobutamine stress echo for a patient with symptomatic AS and an aortic valve with normal SV/SV index, Vmax 3.4m/s, AVA < 1.0 cm2, and mean gradient < 40 mmHg?  

This scenario appears to be one of normal flow, low gradient severe aortic stenosis(NF-LG AS). This is one of the least understood variants of low gradient aortic stenosis. The most important focus should be on avoiding measurement errors during echocardiography, which may lead to underestimation of...

I think the key term here is symptomatic.

Once Sx develops in a patient with an AVA < 1 cm2, the clock starts ticking in terms of adverse events (importantly, death). An AV Ca score is a non-contrast-based imaging tool to prompt Rx if > 2000 male/>1200 female. Indexing the AVA to BSA is also an opti...