Aortic stenosis murmur and heart failure

Aortic stenosis murmur and heart failure

When the stroke volume falls in heart failure, the intensity of aortic stenosis murmur falls and may even be inaudible. This is why critical aortic stenosis comes in the differential diagnosis of dilated cardiomyopathy. Even the Doppler gradient across the aortic valve may be low in such cases and may require inotropic stimulation to assess the true gradient and severity of aortic stenosis.