Aortic stenosis and the case of the missing handbag.

Aortic stenosis is now the most common type of valvular heart disease in Europe and North America. Calcific aortic stenosis affects 2-7% of people aged over 65 years. Dyspnoea, chest pain, and syncope require investigation and surgery is the preferred option for suitable individuals. Operative mortality is 3-5% for those aged under 70 years and 5-15% in older adults. The case reported here illustrates the issues raised when a GP's patient unexpectedly collapses in a public place and other professional agencies become involved. Relevant UK medico-legal requirements of the vehicle licensing agency and the new guidance related to antibiotic prophylaxis and heart valve disease are also discussed.