title: Effect of aortic valve replacement on syncope in patients with aortic stenosis.
abstract: OBJECTIVE
  To determine the role of exertion as a precipitating factor in syncope in patients with aortic stenosis.
  
  
  METHODS
  Follow up for at least one year after aortic valve replacement.
  
  
  METHODS
  Regional cardiac centre.
  
  
  METHODS
  Consecutive patients who underwent aortic valve replacement for aortic stenosis and who had a history of syncope and no other clinically significant cardiac lesion were recruited during a five year period.
  
  
  METHODS
  Patients were interviewed to determine the characteristics of syncope and were divided into those in whom syncope was consistently related to exertion (group 1, 26 patients) and those in whom it was not (group 2, 13 patients). Recurrence of syncope after valve replacement was determined at visits to the clinic.
  
  
  RESULTS
  Groups 1 and 2 did not differ significantly with respect to valve area, age, or sex. In 13 of the 26 patients in group 1 syncope was preceded by angina despite the absence of coronary artery disease, but none of the 13 patients in group 2 had angina. After valve replacement none of group 1 and eight of the 13 patients in group 2 had recurrence of syncope (p < 0.01).
  
  
  CONCLUSIONS
  When patients with aortic stenosis experience syncope unrelated to exertion, the symptom is usually unrelated to the valve disease and another cause should be sought.
authors.affiliation: Department of Cardiology, St Thomas's Hospital, London.
authors.forename: P T
authors.initials: PT
authors.lastname: Wilmshurst
authors.forename: P R
authors.initials: PR
authors.lastname: Willicombe
authors.forename: M M
authors.initials: MM
authors.lastname: Webb-Peploe
mesh_terms: D000368:Aged; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012008:Recurrence; D013575:Syncope / Q000209:etiology*