What are the signs and symptoms of aortic stenosis (AS) in noncardiac surgery patients?

Updated: Jul 16, 2021
  • Author: Lindsay A (Finger) Raleigh, MD; Chief Editor: Sheela Pai Cole, MD  more...
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Furthermore, the hypertrophic LV requires a higher CPP to maintain myocardial oxygen supply in the setting of increased end-diastolic pressure. Thus, decreases in SVR, such as occur during general anesthesia, can result in decreased CPP; patients become particularly susceptible to myocardial ischemia and are at risk for subsequent hemodynamic deterioration. Late in the disease course, patients develop a triad of AS symptoms, as follows:

  • Angina - This occurs when oxygen demand exceeds oxygen supply to the myocardium
  • Syncope - Usually exertional, this may occur as a consequence of the heart's inability to increase stroke volume in response to increased exertion or decreased peripheral vascular resistance (PVR); it may also be due to arrhythmias resulting from the imbalances in myocardial oxygen supply and demand
  • Dyspnea - Generally a late symptom of AS, this is related to congestive heart failure (CHF), both systolic and diastolic, that develops as a result of the stenotic valve and changes to the myocardium

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