History and Red flags > Symptoms

Red Flags and Warnings for Aortic Stenosis

The red flags to consider when taking a patient history.

Red Flags to Consider During a Patient History

The onset of symptoms indicates a worse prognosis and is associated with approximately 50% mortality at 2 years. The cardinal symptoms of severe aortic stenosis are all typically provoked by exertion.

The majority of patients with aortic stenosis are asymptomatic. The red flags to consider when taking a patient history should include:

  • Exertional angina,
  • Breathlessness,
  • Dizziness/syncope,
  • Explore any deterioration in functional status or symptoms of heart failure.

 

Dr Martin Ng states “If an elderly patient presents with shortness of breath, hear them out and put a stethoscope on their chest and see if they have a heart murmur. That could be the first step for them to get treatment.” 

Important! Ask relatives if they have noticed any changes to the patient’s physical activity levels.

Tips for Taking a Patient History

Examination:
Asking specific questions about functional capacity may help to identify if there has been a significant deterioration over a prolonged period.

The character of the pulse tends to be of low volume, reflecting the reduction in flow across the narrowed valve, which is most prominent in the carotid region where the pressure on the palpating finger slowly rises to maximum amplitude (slow rising pulse).

Pulse character
Low volume, slow rising

Pulse pressure
Narrow

Apex beat
Normal

Murmur
Systolic murmur (crescendo-decrescendo)

Listen to heart sounds here. 

Additional features
Soft S21

Patient disclaimer: All content on the Hope for Hearts site is created and published online for general information purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Please see your doctor if you have any questions or concerns.
Reference
  1. GPOnline