Subvalvular aortic stenosis (SAS) is one of the common adult congenital heart diseases, with a prevalence of 6.5%. It is usually diagnosed in the first decade of life. Echocardiography is the test of choice to diagnose SAS. Surgical correction is the best treatment modality, and the prognosis is usually excellent. SAS is considered an acquired disease. It is rarely diagnosed during infancy, but it often manifests in the first decade of life with features of progressive LVOT obstruction, left ventricular hypertrophy (LVH), and aortic regurgitation (AR). A familial form of this disease, Shone syndrome, has also been described.
SAS encompasses a variety of anatomic lesions that can occur either alone or in combination. The following discrete entities have been described in literature
1. Thin, crescent‐shaped membrane just below the aortic valve: discrete SAS. This represents 75% to 85% of SAS cases.
2. Thick fibromuscular ridge.
4. Tunnel or tubular: long, narrow, fibromuscular channel along the LVOT. Most adult patients with SAS are asymptomatic. Symptoms may include pre‐syncope, shortness of breath, or fatigue with physical stress, such as exercise or pregnancy. Surgical correction is the treatment of choice, and the prognosis is usually excellent, with varied recurrence rates depending on the presence of certain risk factors.
Maria Ludmila Setti Aguiar Moro, cardiologist and echocardiographyst ,responsible for the echocardiography laboratory at Santa Casa de Campo Grande-MS / Brazil.