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Aortic stenosis (AS) is commonly underdiagnosed, given its gradually progressive nature from morphological changes in the aortic valve leaflets due to valve fibrosis and calcification to severe haemodynamic obstruction.1 The American Heart Association/American College of Cardiology (AHA/ACC) AS stages, proposed in 2014 and endorsed in 2020, highlight this progression from risk (stage A) to haemodynamic stenosis (stage B), to severe asymptomatic (stages C1–2) and symptomatic (stages D1–3) AS to help identify patients for timely intervention.2 Professional society guidelines recommend follow-up echocardiography in patients with mild AS at 2–3 years (European Society of Cardiology guidelines)1 to 3–5 years (AHA/ACC guidelines),2 though no dedicated follow-up is specified for patients with aortic sclerosis without haemodynamic stenosis. However, existing studies suggest considerable inter-individual variability in the progression from sclerosis to stenosis and in the progression of severity among those with stenosis.3