Aortic Stenosis

How does Aortic Stenosis related to pain and tightness on the chest?
• In 4% of patient with AS, the 1st symptom is sudden death, usually during strenuous exertion
• It is probably due to heart rhythm abnormalities secondary to inadequate blood flow through the narrowed aortic valve
• Due to the increased pressures generated by the left ventricle, the myocardium (muscle) of the LV undergoes hypertrophy (increase in muscle mass).However, the coronary arteries that supply myocardium doesn’t become longer or bigger, so the muscle might become ischemic.
• Thus, the lack of oxygen in the heart muscle causes chest pain and possible abnormal heart rhythm


Chest pain (Angina)
• Chest pain is often described by patient as pressure below the breast bone brought on by on exertion and relieved by rest
• Chest pain is the 1st symptom in 1/3 patients and eventually occurs in 1/2 of patients with AS
• The thickened heart muscle must pump against the high pressure to push blood through the narrowing aortic valve
• This increased heart muscle oxygen demand in excess of the supply delivered in the blood, causing chest pain (angina)

Lawrence
(Part time Chairman of PCL group D) :P