Chest
Volume 93, Issue 5, May 1988, Pages 1083-1087
Journal home page for Chest

Exercise and the Heart
Exercise Testing in Patients with Aortic Stenosis

https://doi.org/10.1378/chest.93.5.1083Get rights and content

Section snippets

CASE REPORT

A 68-year-old retired, physically active high school teacher was evaluated in an emergency room with the complaint of syncope. He had no history of chest pain, symptoms of congestive heart failure, palpitations, or myocardial infarction. A heart murmur had been present since childhood. He quit smoking in 1956, his cholesterol level was 268, and his hypertension had been treated intermittently for five years; there was no diabetes mellitus or family history of heart disease. He was receiving no

DISCUSSION

In this patient, inadequate attention had been paid to warning signs. The initial heavy workload of the Bruce protocol (5 METs), infrequent blood pressure monitoring, continuation of the test despite a blunted blood pressure response, and physician inexperience may all have contributed to this catastrophe. Fortunately, the patient survived and underwent successful valve replacement Recent studies have improved our understanding of the patient with AS, and this knowledge will help prevent such

EXERCISE TESTING IN SUBJECTS WITH AORTIC STENOSIS

Although studies have delineated possible mechanisms for effort syncope in aortic stenosis, a review of the literature (Table 1) demonstrates rare complications from exercise testing when performed with appropriate caution and monitoring. Although used predominantly in pediatric cardiology to assess congenital aortic stenosis and the need for surgical therapy, exercise testing has more recently been performed in adults to resolve disparities between history and clinical findings. With the

First page preview

First page preview
Click to open first page preview

REFERENCES (24)

  • SelzerA.

    Changing aspect of the natural history of valvular aortic stenosis

    N Engl J Med

    (1987)
  • GallavardinL.

    Les syncope d'effort Lyon Med

    (1933)
  • Cited by (0)

    View full text