Bicuspid aortic stenosis cardiac catheterization

1. Cardiac catheterization for the evaluation of aortic stenosis (AS) is an effective diagnostic tool in the asymptomatic adolescent or young adult when results of Doppler echocardiography are equivocal regarding severity of AS or when there is a discrepancy between clinical and noninvasive findings regarding severity of AS. (Level of Evidence: C)

2. Cardiac catheterization is indicated in the adolescent or young adult with AS who has symptoms of angina, syncope, or dyspnea on exertion if the Doppler mean gradient is > 30 mm Hg or the peak velocity is > 3.5 m per second (peak gradient greater than 50 mm Hg). (Level of Evidence: C)

3. Cardiac catheterization is indicated in the asymptomatic adolescent or young adult with AS who develops T-wave inversion at rest over the left precordium if the Doppler mean gradient is > 30 mm Hg or the peak velocity is > 3.5 m per second (peak gradient > 50 mm Hg). (Level of Evidence: C)

1. Cardiac catheterization for the evaluation of AS is a reasonable diagnostic tool in the asymptomatic adolescent or young adult who has a Doppler mean gradient > 40 mm Hg or a peak velocity > 4 m per second (peak gradient greater than 64 mm Hg). (Level of Evidence: C)

2. Cardiac catheterization for the evaluation of AS is reasonable in the adolescent or young adult who has a Doppler mean gradient > 30 mm Hg or a peak velocity > 3.5 m per second (peak gradient > 50 mm Hg) if the patient is interested in athletic participation or becoming pregnant, or if the clinical findings and the Doppler echocardiographic findings are disparate. (Level of Evidence: C)