In a patient with aortic stenosis, which symptom would likely be present during exertion?

In a patient with aortic stenosis, which symptom would likely be present during exertion?

• A. Syncope
• B. Chest pain
• C. Hemoptysis
• D. Abdominal pain

Answer: (A)

In a patient with aortic stenosis, syncope is a common symptom that may occur during exertion due to the impaired ability of the heart to pump blood effectively. Aortic stenosis leads to a narrowing of the aortic valve, which restricts blood flow from the left ventricle to the aorta, especially under increased demand such as during physical activity. When the heart rate increases with exertion, the fixed outflow obstruction caused by the stenosis does not allow for adequate increases in cardiac output. This can result in a drop in blood pressure and reduced cerebral perfusion, often culminating in syncope or near-syncope episodes during or after exertion. While chest pain can also occur due to increased myocardial oxygen demand, it is less specific and may present differently. Hemoptysis and abdominal pain are not typically associated with aortic stenosis and do not fit the clinical picture associated with this condition during physical stress. Thus, syncope is the most likely symptom to be present in a patient with aortic stenosis during exertion due to the hemodynamic changes that occur in this condition.

In a patient with aortic stenosis, syncope is a common symptom that may occur during exertion due to the impaired ability of the heart to pump blood effectively. Aortic stenosis leads to a narrowing of the aortic valve, which restricts blood flow from the left ventricle to the aorta, especially under increased demand such as during physical activity.

When the heart rate increases with exertion, the fixed outflow obstruction caused by the stenosis does not allow for adequate increases in cardiac output. This can result in a drop in blood pressure and reduced cerebral perfusion, often culminating in syncope or near-syncope episodes during or after exertion.

While chest pain can also occur due to increased myocardial oxygen demand, it is less specific and may present differently. Hemoptysis and abdominal pain are not typically associated with aortic stenosis and do not fit the clinical picture associated with this condition during physical stress. Thus, syncope is the most likely symptom to be present in a patient with aortic stenosis during exertion due to the hemodynamic changes that occur in this condition.