NPPB and aortic stenosis: Current guidelines suggest intervention in patients with severe aortic stenosis when symptoms occur or in those without symptoms and left ventricular ejection fraction (LVEF) <50% or abnormal exercise test or Vmax >5 m/s or brain natriuretic peptide (BNP) more than three times the upper normal value or features of rapid disease progression.3 19 20 However, it can be challenging to unmask these on many occasions, especially in patients with sedentary life or in the frail elderly population.