In long-standing aortic stenosis, which is the most common secondary finding?

In long-standing aortic stenosis, the most common secondary finding is left ventricular hypertrophy. This occurs as a compensatory response to the increased afterload that the left ventricle faces due to the narrowed aortic valve. As blood flow is impeded from the left ventricle into the aorta, the ventricle must work harder to generate the necessary pressure to overcome this obstruction. Over time, the muscle walls of the left ventricle thicken, leading to hypertrophy.

This condition often occurs in conjunction with other manifestations of cardiac stress but is primarily characterized by the left ventricle's adaptation to sustained pressure overload. The hypertrophy can lead to changes in the myocardial structure, potentially progressing to heart failure if the underlying aortic stenosis is not addressed. Understanding this pathophysiological response is crucial for cardiac sonographers when assessing patients with aortic stenosis and monitoring their heart function and structure over time.