Why is hypotension bad in aortic stenosis

To start, Dr. Yes, valve disease can cause low blood pressure. If valvular heart disease is not caught early patients generally present with symptoms of fatigue, shortness of breath, dyspnea on exertion that could be symptoms of low blood pressure or high blood pressure. Then, Dr. Mehall addressed how aortic, mitral and tricuspid valve disease can impact the heart and blood pressure in different ways:.

For example, severe aortic stenosis can cause hypotension or low blood pressure with exertion secondary to poor output or excretion of blood through stenotic valve. One of the criteria for diagnosis of aortic stenosis in patients with presumed asymptomatic aortic stenosis is to place a patient on a supervised treadmill and if BP drops approximately 10mmHg with exercise then patient is considered symptomatic severe aortic stenosis. Therefore, symptoms of low blood pressure with exertion or even at rest.

In the setting of mitral regurgitation patients can have low blood pressure due to poor forward flow leading to lower blood pressure readings. Journal of Clinical Pathways. Journal of Invasive Cardiology. Pharmacy Learning Network. Podiatry Today. Psych Congress Network. The Dermatologist. Today's Wound Clinic. Vascular Disease Management. Veterans Health Today. Amputation Prevention Symposium. Clinical Pathways Congress.

Dermatology Week. EMS World Expo. Evolution of Psychotherapy. Great Debates and Updates in Gastrointestinal Malignancies. Great Debates and Updates in Hematologic Malignancies. NCAD East. Oncology Clinical Pathways Congress. Personalized Therapies in Thoracic Oncology. Psych Congress.

Psych Congress Elevate. Symposium on Advanced Wound Care. Symposium on Clinical Interventional Oncology. Editorial Description. Our Partners. Always have a defibrillator available because external compressions are essentially useless with significant stenosis.

Patients with AS are best thought of based on their hemodynamic derangements — they have increased myocardial oxygen demands, reduced left ventricular filling, and, with time, reduced contractility.

With regards to myocardial perfusion, diastolic volume must be maintained. Normal sinus is critical in order to fill the LV, with HR being optimal these patients often behave HR-dependent, thus bradycardia can be devastating.

Volatile or intravenous general anesthesia can be used, although volatile anesthetics may reduce sinus automaticity, leading to a junctional rhythm, as well as produce myocardial depression, thus an opiate-based anesthetic is preferred. If a volatile agent is used, it should be titrated carefully to avoid myocardial depression, vasodilation, or loss of NSR. Tachycardia and hypertension, which are poorly tolerated, should be treated by increasing anesthetic depth.

If an adrenergic blocking agent is used, esmolol is preferable. The patients were randomized to receive either propofol or etomidate for induction of anaesthesia.

Haemodynamic parameters, i.