Symptomatology of severe aortic stenosis
| Symptom | Aetiology | Potential questions to ask: |
| Angina | Supply–demand imbalance: coexistent coronary disease and fixed cardiac output versus hypertrophied myocardium. | ‘Do you get chest pain or discomfort when walking or doing other activities?’ |
| Breathlessness/reduced exercise capacity | Reduced LV compliance, increased left ventricular end-diastolic and pulmonary capillary pressures. | ‘Can you walk ask many stairs as this time last year?’ ‘Can you keep up with your friends?’ |
| Presyncope/syncope (important to elicit any exertional component) | Fixed cardiac output, skeletal muscle vasodilation on exertion and resultant cerebral hypoperfusion. | ‘Have you felt lightheaded like you might faint?’ ‘Have you had any fainting or blackout episodes?’ |
| Palpitations | Development of atrial or ventricular arrhythmia, myocardial scarring. | ‘Are you aware of your heart racing?’ |
LV, left ventricular.