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Significant stenosis of the aortic valve impairs blood flow across the valve, causing turbulence, and increases the afterload on the left ventricle. Causes are congenital, rheumatic, and degenerative, and findings may differ with each cause.

Other conditions may mimic the murmur of aortic stenosis without obstructing flow:

■ Aortic sclerosis, a stiffening of aortic valve leaflets associated with aging

■ A bicuspid aortic valve, a congenital condition, which may not be recognized until adulthood

■ A dilated aorta, as from arteriosclerosis, syphilis, or Marian's syndrome

■ A pathologically increased flow across the aortic valve during systole, as in aortic regurgitation

Hypertrophic Cardiomyopathy

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