Describe the pathologic features of calcific aortic valve stenosis.

Describe the pathologic features of calcific aortic valve stenosis.

• A. Rheumatic Aschoff bodies on valve leaflets.
• B. Myxomatous degeneration of the leaflets.
• C. Calcific nodules on the aortic valve leaflets with reduced mobility; LV concentric hypertrophy.
• D. Infectious vegetations on the valve.

Answer: (C)

Calcific aortic valve stenosis presents with calcific nodules on the aortic valve leaflets that stiffen the cusps and reduce their mobility, leading to outflow obstruction. These calcific deposits typically develop with age (and may be more pronounced on congenitally bicuspid valves), starting at the base of the cusps and progressing toward the center so the leaflets become thickened and immobile. The resulting increased afterload on the left ventricle drives concentric hypertrophy as the ventricle works harder to overcome the narrowed valve. This combination of nodular calcification with restricted leaflet motion and LV concentric hypertrophy is distinct from rheumatic valve disease (which features commissural fusion and leaflet thickening), myxomatous degeneration (which causes floppy leaflets and valve prolapse), or infectious vegetations (which are destructive friable masses).

Calcific aortic valve stenosis presents with calcific nodules on the aortic valve leaflets that stiffen the cusps and reduce their mobility, leading to outflow obstruction. These calcific deposits typically develop with age (and may be more pronounced on congenitally bicuspid valves), starting at the base of the cusps and progressing toward the center so the leaflets become thickened and immobile. The resulting increased afterload on the left ventricle drives concentric hypertrophy as the ventricle works harder to overcome the narrowed valve. This combination of nodular calcification with restricted leaflet motion and LV concentric hypertrophy is distinct from rheumatic valve disease (which features commissural fusion and leaflet thickening), myxomatous degeneration (which causes floppy leaflets and valve prolapse), or infectious vegetations (which are destructive friable masses).