PMC7266867_01
Transthoracic echocardiogram (January 2017): Continuous wave doppler in the apical 5 chamber view demonstrating a maximum transaortic velocity of 2.7 m/s.
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F1
Transthoracic echocardiogram (January 2018): Continuous wave doppler in the apical 5 chamber view (A) and right parasternal long axis view (B) demonstrating a maximum transaortic velocity of 4.1 m/s.
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F2
TTE revealed an elevated Vmax of 4.1 m/s (Figure 2) suggestive of a significantly elevated transvalvular pressure gradient.
Transthoracic echocardiogram (August 2018): Continuous wave doppler in the apical 5 chamber view (A) and right parasternal long axis view (B) demonstrating a maximum transaortic velocity of 3.9 m/s.
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F3
The patient's general practitioner commenced warfarin and after a 6-month period, repeat TTE in August 2018 revealed slight improvement in the transaortic Vmax which reduced to 3.9 m/s (Figure 3).
Transthoracic echocardiogram (March 2019): Continuous wave doppler in the apical 5 chamber view (A) and right parasternal long axis view (B) demonstrating a maximum transaortic velocity of 3.0 m/s.
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F4
TTE in March 2019 showed the transaortic velocity to have reduced to 3 m/s giving a mean transvalvular gradient of only 18 mmHg (Figure 4) compared to a previous mean gradient of 40 mmHg in January 2018.