Dyspnea in aortic stenosis: Appearances can be deceptive

Abstract Valvular aortic stenosis is the most common valvular disorder in Europe. Although recommended, stress exams are still underused in its evaluation. We report the case of a 60-year-old man who, following a routine electrocardiogram with abnormal ventricular repolarization, underwent stress te...

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Bibliographic Details
Published in:Revista portuguesa de cardiologia (English ed.) 2012-01, Vol.31 (1), p.27-30
Main Authors: Cordeiro Piçarra, Bruno, Miranda, Rita, Cotrim, Carlos, Almeida, Ana Rita, Lopes, Luís, Fazendas, Paula, João, Isabel, Pereira, Hélder
Format: Article
Language:English
Subjects:
Aortic stenosis
Cardiovascular
Ecocardiograma de esforço
Estenose aórtica
Gradiente intraventricular
Intraventricular gradient
Stress echocardiography
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Summary:Abstract Valvular aortic stenosis is the most common valvular disorder in Europe. Although recommended, stress exams are still underused in its evaluation. We report the case of a 60-year-old man who, following a routine electrocardiogram with abnormal ventricular repolarization, underwent stress testing, which was positive for myocardial ischemia, and an echocardiogram that revealed moderate aortic stenosis. Cardiac catheterization showed no angiographic coronary lesions and an intraventricular gradient of 45 mmHg. In view of the latter, stress echocardiography was performed, which documented an increase in the intraventricular gradient from 30 mmHg to 131 mmHg. Repeated stress echocardiography under treatment with bisoprolol showed an increase in test duration and a maximum intraventricular gradient at peak exercise of 36 mmHg. Stress exams may have an important role in the diagnostic and therapeutic management of patients with aortic stenosis.
ISSN:2174-2049
2174-2049
DOI:10.1016/j.repce.2011.12.002