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Detailed assessment of aortic valve needs to be done in patients with coexistent mitral stenosis. Each modality for assessment of aortic stenosis has its own limitations and a decision regarding treatment needs to be taken based on combined analysis of all the parameters. Dimensionless velocity index is a relatively less time-consuming, flow independent measure of aortic stenosis. Prompt recognition of this concealed aortic stenosis helps to avoid repeat valve surgery. Subsequently, patient was sent for dual valve replacement.<\/jats:p>","DOI":"10.1136\/bcr-2020-236141","type":"journal-article","created":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T16:10:17Z","timestamp":1598890217000},"page":"e236141","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Conundrum of aortic stenosis in a case of multivalvular rheumatic heart disease: perspicuity is in the details"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2512-4689","authenticated-orcid":false,"given":"Ahamed Shaheer","family":"Ahmed","sequence":"first","affiliation":[{"name":"Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Kumar","sequence":"additional","affiliation":[{"name":"Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aseem","family":"Basha","sequence":"additional","affiliation":[{"name":"Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,8,31]]},"reference":[{"key":"2025082723460548000_13.8.e236141.1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.ihj.2014.03.010","article-title":"Incidence and patterns of valvular heart disease in a tertiary care high-volume cardiac center: a single center experience","volume":"66","author":"Manjunath","year":"2014","journal-title":"Indian Heart J"},{"key":"2025082723460548000_13.8.e236141.2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-307020"},{"key":"2025082723460548000_13.8.e236141.3","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jen303"},{"key":"2025082723460548000_13.8.e236141.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.002310"},{"key":"2025082723460548000_13.8.e236141.5","unstructured":"O\u2019Sullivan CJ , Praz F , Stortecky S , et al . 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