Home > SOP Information > SOPs and Supporting Information – alphabetic listing > A to B > Aortic Stenosis G004

Aortic Stenosis G004

Date published 
Thursday, June 11, 2015
Last amended 
Monday, January 17, 2022
Current RMA Instruments
Reasonable Hypothesis [1]
13 of 2022
Balance of Probabilities [2]
14 of 2022
Changes from previous Instruments

SOP Bulletin 228 [3]

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.

Rulebase for aortic stenosis

Place holder node for Rulebase for aortic stenosis

Chronic renal failure

Aortic stenosis - Chronic renal failure Factor

Last reviewed for CCPS 20 December 2002.

Preliminary questions [32331]

9041 [5] there is some evidence that chronic renal failure may be a factor in the development or worsening of the condition under consideration.

32332 [6] the veteran has chronic renal failure which required renal dialysis or renal transplantation.

32333 — the veteran has established the causal connection between the chronic renal failure and VEA service for aortic stenosis.

32334 [7] the veteran was suffering from chronic renal failure, which required renal dialysis or renal transplantation, before the clinical onset of the condition under consideration.

32335 — the veteran has established the causal connection between the chronic renal failure and VEA service for the clinical onset of aortic stenosis.

32338 — the veteran has established the causal connection between the chronic renal failure and operational service for the clinical onset of aortic stenosis.

or

32339 — the veteran has established the causal connection between the chronic renal failure and eligible service for the clinical onset of aortic stenosis.

or

[8]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[9]7335

the condition under consideration permanently worsened.

[10]32336

the veteran was suffering from chronic renal failure, which required renal dialysis or renal transplantation, before the clinical worsening of the condition under consideration.

32337 — the veteran has established the causal connection between the chronic renal failure and VEA service for the clinical worsening of aortic stenosis.

32340 — the veteran has established the causal connection between the chronic renal failure and operational service for the clinical worsening of aortic stenosis.

or

32341 — the veteran has established the causal connection between the chronic renal failure and eligible service for the clinical worsening of aortic stenosis.

Clinical onset and operational service [32338]

32342 — the chronic renal failure, which required renal dialysis or renal transplantation, is causally related to operational service. [11] [12]

Clinical onset and eligible service [32339]

32343 — the chronic renal failure, which required renal dialysis or renal transplantation, is causally related to eligible service. [13] [12]

Clinical worsening and operational service [32340]

32342 — the chronic renal failure, which required renal dialysis or renal transplantation, is causally related to operational service. [14] [12]

[15]32344

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the chronic renal failure, which required renal dialysis or renal transplantation, is causally related.

Clinical worsening and eligible service [32341]

32343 — the chronic renal failure, which required renal dialysis or renal transplantation, is causally related to eligible service. [16] [12]

[17]32345

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the chronic renal failure, which required renal dialysis or renal transplantation, is causally related. [18]

Hypertension

Aortic stenosis - Hypertension Factor

Last reviewed for CCPS 20 December 2002.

Preliminary questions [32351]

317 [19] the veteran has hypertension.

32352 — the veteran has established the causal connection between the hypertension and operational service for aortic stenosis.

[20]32355

the veteran's hypertension was present at the time of the clinical onset of the condition under consideration.

32353 — the veteran has established the causal connection between the hypertension and operational service for the clinical onset of aortic stenosis.

or

[21]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[9]7335

the condition under consideration permanently worsened.

[10]32356

the veteran's hypertension was present at the time of the clinical worsening of the condition under consideration.

32354 — the veteran has established the causal connection between the hypertension and operational service for the clinical worsening of aortic stenosis.

Clinical onset and operational service [32353]

334 — the hypertension is causally related to operational service. [22]

Clinical worsening and operational service [32354]

334 — the hypertension is causally related to operational service. [23]

[24]7899

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the hypertension is causally related. [25]

Inability to obtain appropriate clinical management for aortic stenosis

Aortic stenosis - Inability to obtain appropriate clinical management for aortic stenosis Factor

Last reviewed for CCPS 20 December 2002.

Investigative Documents

Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM]

Preliminary questions [32577]

11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.

[26]7066

there is some evidence that an inability to obtain appropriate clinical management for the condition under consideration may be a factor in the worsening of the condition under consideration.

7334 [27] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[9]7335

the condition under consideration permanently worsened.

[10]7378

the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.

7379 [28] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration.

11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration.

11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration.

or

11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration.

Clinical worsening and operational service [11235]

[29]7384

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service.

[30]21084

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service, as a causal result of operational service.

[31]7387

the veteran's inability to obtain appropriate clinical management for the condition under consideration during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[32]7389

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.

7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [33] [34]

[35]7392

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.

Clinical worsening and eligible service [11236]

[36]7385

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service.

[37]7386

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service, as a causal result of eligible service.

[38]7388

the veteran's inability to obtain appropriate clinical management for the condition under consideration during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[32]7389

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.

7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [33] [34]

[39]7393

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related. [40]

Infective endocarditis

Aortic stenosis - Infective endocarditis Factor

Last reviewed for CCPS 20 December 2002.

Preliminary questions [11303]

11327 [41] the veteran has had infective endocarditis at some time.

11328 [42] the veteran has suffered from an identifiable form of infective endocarditis, an inflammation of the endocardium caused by infection with microorganisms.

11329 — the veteran has established the causal connection between the identified illness or injury, a type of infective endocarditis, and VEA service for the condition under consideration.

[43]11336

the veteran had the identified illness or injury, a type of infective endocarditis, before the clinical onset of the condition under consideration.

11330 — the veteran has established the causal connection between the infective endocarditis and VEA service for the clinical onset of the condition under consideration.

11332 — the veteran has established the causal connection between the infective endocarditis and operational service for the clinical onset of the condition under consideration.

or

11333 — the veteran has established the causal connection between the infective endocarditis and eligible service for the clinical onset of the condition under consideration.

or

[44]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[9]7335

the condition under consideration permanently worsened.

[10]11337

the veteran had the identified illness or injury, a type of infective endocarditis, before the clinical worsening of the condition under consideration.

11331 — the veteran has established the causal connection between the infective endocarditis and VEA service for the clinical worsening of the condition under consideration.

11334 — the veteran has established the causal connection between the infective endocarditis and operational service for the clinical worsening of the condition under consideration.

or

11335 — the veteran has established the causal connection between the infective endocarditis and eligible service for the clinical worsening of the condition under consideration.

Clinical onset and operational service [11332]

11338 — the identified illness or injury, a type of infective endocarditis, is causally related to operational service. [45] [46]

Clinical onset and eligible service [11333]

11339 — the identified illness or injury, a type of infective endocarditis, is causally related to eligible service. [47] [46]

Clinical worsening and operational service [11334]

11338 — the identified illness or injury, a type of infective endocarditis, is causally related to operational service. [48] [46]

[49]11340

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a type of infective endocarditis, is causally related.

Clinical worsening and eligible service [11335]

11339 — the identified illness or injury, a type of infective endocarditis, is causally related to eligible service. [50] [46]

[51]11341

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a type of infective endocarditis, is causally related. [52]

Systemic lupus erythematosus

Aortic stenosis - Systemic lupus erythematosus Factor

Last reviewed for CCPS 20 December 2002.

Preliminary questions [11304]

21956 [53] there is some evidence that systemic lupus erythematosus may be a factor in the development or worsening of the condition under consideration.

2576 [53] the veteran has had systemic lupus erythematosus at some time.

11342 — the veteran has established the causal connection between the systemic lupus erythematosus and VEA service for the condition under consideration.

[54]11348

the veteran was suffering from systemic lupus erythematosus before the clinical onset of the condition under consideration.

11343 — the veteran has established the causal connection between the systemic lupus erythematosus and VEA service for the clinical onset of the condition under consideration.

11345 — the veteran has established the causal connection between the systemic lupus erythematosus and operational service for the clinical onset of the condition under consideration.

or

11346 — the veteran has established the causal connection between the systemic lupus erythematosus and eligible service for the clinical onset of the condition under consideration.

or

[55]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[9]7335

the condition under consideration permanently worsened.

[10]11349

the veteran was suffering from systemic lupus erythematosus before the clinical worsening of the condition under consideration.

11344 — the veteran has established the causal connection between the systemic lupus erythematosus and VEA service for the clinical worsening of the condition under consideration.

11347 — the veteran has established the causal connection between the systemic lupus erythematosus and operational service for the clinical worsening of the condition under consideration.

or

11352 — the veteran has established the causal connection between the systemic lupus erythematosus and eligible service for the clinical worsening of the condition under consideration.

Clinical onset and operational service [11345]

2582 — the systemic lupus erythematosus is causally related to operational service. [56] [57]

Clinical onset and eligible service [11346]

2583 — the systemic lupus erythematosus is causally related to eligible service. [58] [57]

Clinical worsening and operational service [11347]

2582 — the systemic lupus erythematosus is causally related to operational service. [59] [57]

[60]11350

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the systemic lupus erythematosus is causally related.

Clinical worsening and eligible service [11352]

2583 — the systemic lupus erythematosus is causally related to eligible service. [61] [57]

[62]11351

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the systemic lupus erythematosus is causally related. [63]

Therapeutic radiation to the mediastinum or the chest wall overlying the heart

Aortic stenosis - Therapeutic radiation to the mediastinum or the chest wall overlying the heart Factor

Last reviewed for CCPS 20 December 2002.

Preliminary questions [26989]

26990 [64] there is some evidence that therapeutic radiation involving the mediastinum or the chest wall region overlying the heart may be a factor in the development or worsening of the condition under consideration.

26991 [64] the veteran has undergone a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart at some time.

26994 [65] the veteran underwent a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart as treatment for an illness or injury which is identifiable.

26992 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and VEA service for the condition under consideration.

[66]33440

the veteran underwent a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart for treatment of the identified illness or injury before the clinical onset of the condition under consideration.

26993 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and VEA service for the clinical onset of the condition under consideration.

26997 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and operational service for the clinical onset of the condition under consideration.

or

26998 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and eligible service for the clinical onset of the condition under consideration.

or

[67]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[9]7335

the condition under consideration permanently worsened.

[10]26995

the veteran underwent a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart for treatment of the identified illness or injury before the clinical worsening of the condition under consideration.

26996 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and VEA service for the clinical worsening of the condition under consideration.

26999 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and operational service for the clinical worsening of the condition under consideration.

or

27000 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and eligible service for the clinical worsening of the condition under consideration.

Clinical onset and operational service [26997]

27004 — the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to operational service. [68] [69]

Clinical onset and eligible service [26998]

27005 — the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to eligible service. [70] [69]

Clinical worsening and operational service [26999]

27004 — the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to operational service. [71] [69]

[72]27006

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related.

Clinical worsening and eligible service [27000]

27005 — the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to eligible service. [73] [69]

[74]27007

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related. [75]

Source URL (modified on 31/01/2022 - 11:35am): https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/b/aortic-stenosis-g004-i350i352

Links
[1] http://www.rma.gov.au/assets/SOP/2022/a8bab49d76/013.pdf
[2] http://www.rma.gov.au/assets/SOP/2022/617a7589d2/014.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20228.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63284%23comment-form
[5] https://clik.dva.gov.au/ccpsk010rc-23
[6] clikpopup://CCPS/Chronic renal failure required renal dialysis or renal transplantation
[7] clikpopup://CCPS/Chronic renal failure required renal dialysis or renal transplantation before onset
[8] clikpopup://CCPS/reject32334No
[9] clikpopup://CCPS/Reject/OnsetAfterService
[10] clikpopup://CCPS/Reject/NoPermanentWorsening
[11] clikpopup://CCPS/reject32336No
[12] clikpopup://CCPS/reject32342,32343No
[13] clikpopup://CCPS/reject32343No
[14] clikpopup://CCPS/reject32342No
[15] clikpopup://CCPS/Onset prior to operational chronic renal failure requiring renal dialysis or renal transplantation
[16] clikpopup://CCPS/reject32344No
[17] clikpopup://CCPS/Onset prior to eligible chronic renal failure requiring renal dialysis or renal transplantation
[18] clikpopup://CCPS/reject32345No
[19] https://clik.dva.gov.au/ccpsg020rc
[20] clikpopup://CCPS/reject317No
[21] clikpopup://CCPS/reject32355No
[22] clikpopup://CCPS/reject32356No
[23] clikpopup://CCPS/reject334No
[24] clikpopup://CCPS/Onset occurred prior to operational service to which hypertension is causally related
[25] clikpopup://CCPS/reject7899No
[26] https://clik.dva.gov.au/ccpsother-31
[27] https://clik.dva.gov.au/node/68642
[28] clikpopup://CCPS/Aortic stenosis/ACM - contributed to worsening
[29] clikpopup://CCPS/ACM/NoContribution
[30] clikpopup://CCPS/ACM/NotOpService
[31] clikpopup://CCPS/ACM/NotOperDuties
[32] clikpopup://CCPS/rejectwilful
[33] clikpopup://CCPS/ACM/NoIllness
[34] clikpopup://CCPS/reject7390,7391No
[35] clikpopup://CCPS/Aortic stenosis/ACM - onset prior to operational service
[36] clikpopup://CCPS/ACM/OnsetFailOper
[37] clikpopup://CCPS/ACM/NotEligService
[38] clikpopup://CCPS/ACM/NotEligDuties
[39] clikpopup://CCPS/Aortic stenosis/ACM - onset prior to eligible service
[40] clikpopup://CCPS/ACM/OnsetFailElig
[41] https://clik.dva.gov.au/ccpsg036rc-35
[42] https://clik.dva.gov.au/11303-infective-endocarditis
[43] clikpopup://CCPS/reject11328No
[44] clikpopup://CCPS/reject11336No
[45] clikpopup://CCPS/reject11337No
[46] clikpopup://CCPS/reject11338,11339No
[47] clikpopup://CCPS/reject11339No
[48] clikpopup://CCPS/reject11338No
[49] clikpopup://CCPS/Onset of aortic stenosis prior to operational service to which infective endocarditis is related
[50] clikpopup://CCPS/reject11340No
[51] clikpopup://CCPS/Onset of aortic stenosis prior to eligible service to which infective endocarditis is related
[52] clikpopup://CCPS/reject11341No
[53] https://clik.dva.gov.au/ccpsf001rc-0
[54] clikpopup://CCPS/reject2576No
[55] clikpopup://CCPS/reject11348No
[56] clikpopup://CCPS/reject11349No
[57] clikpopup://CCPS/reject2582,2583No
[58] clikpopup://CCPS/reject2583No
[59] clikpopup://CCPS/reject2582No
[60] clikpopup://CCPS/Onset of aortic stenosis prior to operational service to which systemic lupus erythematosus is related
[61] clikpopup://CCPS/reject11350No
[62] clikpopup://CCPS/Onset of aortic stenosis prior to eligible service to which systemic lupus erythematosus is related
[63] clikpopup://CCPS/reject11351No
[64] https://clik.dva.gov.au/ccpsg006rc-15
[65] clikpopup://CCPS/Therapeutic radiation involving the mediastinum or chest wall region overlying the heart for illness or injury
[66] clikpopup://CCPS/reject26994No
[67] clikpopup://CCPS/reject33440No
[68] clikpopup://CCPS/reject26995No
[69] clikpopup://CCPS/reject27004,27005No
[70] clikpopup://CCPS/reject27005No
[71] clikpopup://CCPS/reject27004No
[72] clikpopup://CCPS/Onset of aortic stenosis prior to operational service which ill/inj requiring therapeutic radiation is causally related
[73] clikpopup://CCPS/reject27006No
[74] clikpopup://CCPS/Onset of aortic stenosis prior to eligible service which ill/inj requiring therapeutic radiation is causally related
[75] clikpopup://CCPS/reject27007No