One or more of the following symptoms can occur in patients with aortic stenosis:
• Shortness of breath: This can occur at rest or with activity. It can limit a patient’s ability to tolerate exercise. This occurs when adequate amounts of oxygen-rich blood do not reach the coronary arteries or as blood backs up into the lungs.
• Chest pain or pressure referred to as angina: Chest pain or pressure most often occurs with or right after activity and improves with rest. The coronary arteries supply blood to the heart muscle. They branch off from the aorta just above the aortic valve. If enough blood does not get to the coronary arteries, the heart muscle is deprived of oxygen-rich blood and chest pain develops. In addition, the heart muscle can become thickened in response to the high pressure, but the arteries supplying blood to the area remain unchanged. Therefore, the muscle does not get an adequate supply of blood, resulting in chest pain.
• Fatigue: Due to the gradual onset, fatigue is often not recognized early on or it is thought to be related to other factors.
• Palpitations: These are uncomfortable sensations in the chest that feel like the heart is pounding or racing. These sensations can be a result of an abnormal heart rhythm and may be associated with sweating, shortness of breath or chest pain. The episodes may last only seconds or continue for long periods of time.
• Lightheadedness or fainting spells (also called syncope): This can occur when changing positions or with activity. These symptoms usually occur because the brain is not getting enough blood flow due to an obstruction in the heart or an abnormal heart rhythm. If you experience a fainting spell, you should report it to your doctor immediately.