Combined valvular aortic stenosis, hypertrophic subaortic stenosis and coronary artery disease: successful surgical correction

A 51 year old woman with angina pectoris due to combined valvular aortic stenosis, hypertrophic subaortic stenosis and coronary artery disease is described. The diagnosis was first suspected following echocardiography. Discussed is the importance of excluding associated coronary artery disease and hypertrophic subaortic stenosis in patients with valvular aortic stenosis. A pre- and post-PVC aortic pressure response is described pathognomonic of coexistent valvular and hypertrophic subaortic stenosis. The patient underwent successful surgical correction of all three lesions.