Tuesday, September 11, 2018

Vasodilators in severe AS

Q: What is the peril of using vasodilators in the presence of a severe fixed aortic stenosis?


Answer: Use of vasodilators in the presence of a severe fixed aortic valve stenosis reduces the systemic blood pressure and reduces the coronary artery perfusion pressure. Likelihood of coronary artery disease in such a patient is high and decrease coronary perfusion may lead to myocardial ischemia. These patients are "afterload fixed and preload dependent"! so vasodilators do not serve the purpose of afterload reduction. 

Vasodilators in mild to moderate AS patients can still be beneficial but should be managed only by the experienced physicians.

#cardiology



References: 


Zakkar M, Bryan A J, Angelini G D. Aortic stenosis: diagnosis and management BMJ 2016; 355 :i5425

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