title: [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 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. Repeat 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.
authors.affiliation: Serviço de Cardiologia, Hospital Espírito Santo, Évora, Portugal. bcpicarra@hotmail.com
authors.forename: Bruno
authors.initials: B
authors.lastname: Cordeiro Piçarra
authors.forename: Rita
authors.initials: R
authors.lastname: Miranda
authors.forename: Carlos
authors.initials: C
authors.lastname: Cotrim
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Almeida
authors.forename: Luís
authors.initials: L
authors.lastname: Lopes
authors.forename: Paula
authors.initials: P
authors.lastname: Fazendas
authors.forename: Isabel
authors.initials: I
authors.lastname: João
authors.forename: Hélder
authors.initials: H
authors.lastname: Pereira
mesh_terms: D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis*; D004417:Dyspnea / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged