Table 2

Symptomatology of severe aortic stenosis

SymptomAetiologyPotential questions to ask:
AnginaSupply–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 capacityReduced 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?’
(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?’
PalpitationsDevelopment of atrial or ventricular arrhythmia, myocardial scarring.‘Are you aware of your heart racing?’
  • LV, left ventricular.