A diagnostic pitfall of CT calcium scoring in paradoxical low-flow, low-gradient severe aortic stenosis with rheumatic morphology: a case report
Jun Yoshida, Toraaki Okuyama, Hiromasa Yamamoto, Utaro Taga, Michifumi Tokuda · 2026
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Description
Jun Yoshida and colleagues present a 2026 case where a calcium score nearly hid severe aortic valve narrowing. An 82-year-old woman had earlier surgery for rheumatic mitral disease and was referred for aortic stenosis checks. Standard ultrasound suggested severe narrowing with low flow and low gradient, a confusing pattern.
Her CT calcium score fell below the female cut-off for severe disease, arguing against the ultrasound. Three-dimensional imaging through the food pipe showed fused valve edges and thickened leaflet tips instead. Direct measurement there confirmed severe narrowing driven by scarring rather than calcium bulk. A catheter valve implant followed, and her walking distance improved markedly within the follow-up reported.
Catalog record
| CREATOR | Jun Yoshida, Toraaki Okuyama, Hiromasa Yamamoto, Utaro Taga, Michifumi Tokuda |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 16 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |