Calcified aortic valve disease in the elderly most likely represents which diagnosis?

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Senile calcific aortic stenosis is the pattern you’d expect in an elderly person with calcified aortic valve disease. With aging, calcific deposits accumulate on the aortic valve cusps, making them stiff and causing the orifice to narrow. That creates a fixed obstruction to left ventricular outflow, prompting the heart to develop concentric hypertrophy to cope with the higher afterload. Over time this leads to symptoms such as exertional dyspnea, angina, and possibly syncope. The classic finding is a harsh systolic murmur heard best at the right upper sternal border, often with a soft or delayed second heart sound. This course is distinct from aortic regurgitation, which involves valve leakage rather than narrowing, and from mitral stenosis or tricuspid valve disease, which affect other valves and processes.