Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 228

ICD Coding

• ICD-9-CM Codes: 424.1
• ICD-10-AM Codes: I35.0, I35.2

Brief description

Aortic stenosis is a narrowing of the opening of the aortic valve in the heart.  This narrowing restricts blood flow from the left ventricle of the heart into the aorta.   

Confirming the diagnosis

The diagnosis may be provisionally made from findings on clinical examination and is generally confirmed by echocardiogram (heart ultrasound).  Cardiac catheterisation may be undertaken in some cases and provides a definitive diagnosis.  Symptoms are not required for diagnosis but will typically be present. Note that aortic stenosis due to rheumatic fever is covered by a different SOP.  Obstruction to blood flow due to narrowing above or below the aortic valve is not covered by this SOP. 

The relevant medical specialist is a cardiologist.

Additional diagnoses covered by SOP

• Nil

Conditions not covered by SOP

• Aortic incompetence^#
• Aortic regurgitation^#
• Aortic sclerosis (thickened aortic valve but without obstructed blood flow)^#
• Aortic stenosis due to rheumatic fever* - rheumatic heart disease SOP
• Aortic valve calcification without valve obstruction^#
• Congenital aortic stenosis^#
• Hypertrophic subaortic stenosis^#

* another SOP applies

^# non-SOP condition

Clinical onset

Clinical onset will generally be at the time of diagnosis.  The condition is asymptomatic in most mild to moderate cases.  In severe cases non-specific symptoms of shortness of breath, angina and fainting spells (syncope) may occur. 

Clinical worsening

Gradual progresion of disease is usual.  Evidence of deterioration beyond the normal course of the disease is required for clinical worsening to be considered.  Appropriate treatment involves monitoring of the condition in the early stages.  Medical therapy is ineffective.  Surgical treatment may become necessary for more severe disease.