HTN and Aortic Stenosis

[Noyac]

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Can you have severe or even critical Aortic Stenosis with a BP of 150/80, 180/90 or even 195/99?

We have seen a few here on this site claim that it isn't possible. I have partners that claim this. What's the truth?

 

[SleepIsGood]

Can you have severe or even critical Aortic Stenosis with a BP of 150/80, 180/90 or even 195/99?

We have seen a few here on this site claim that it isn't possible. I have partners that claim this. What's the truth?

I have seen echos that state "severe Aortic Stenosis" and their BP was in the range of 140's/80s.

I'm curious to know the answer as well to your question, because people on here claim that it's impossible.

 

[proman]

Yes, it's well described in the literature. I found one reference that included a 1931 citation documenting hypertension and AS. Here is one case report from BMJ 1983 where the patient had a aortic gradient of 82 and BPs from 160/95 to 200/110. Cathed for syncope.

http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1548333&pageindex=1

 

[Planktonmd]

It is possible to have elevated blood pressure during the progress of aortic stenosis but the ultimate result is usually hypotension when the pump starts failing and becomes unable to overcome the huge gradient.
This is why it is unlikely to see a symptomatic (angina, syncope and CHF) aortic stenosis with elevated systemic pressure.
We don't see patients with terminal stage aortic stenosis that frequently anymore since the threshold for valve replacement has been lowered significantly over the years. This is why many physicians have not really seen the natural progress of the disease and what happens during the final stages.

 

[urge]

Can you have severe or even critical Aortic Stenosis with a BP of 150/80, 180/90 or even 195/99?

We have seen a few here on this site claim that it isn't possible. I have partners that claim this. What's the truth?

Yes. I have seen up to 160's/90's. I have also seen LV pressures 0f 280's.

 

[Tenesma]

i agree that symptomatic patients tend to run more normotensive --- the LV is just giving up.

but just because the pump is failing doesn't mean you can't have higher pressures (until they pass out 🙂 ).... in fact, in the presence of some regurgitation you (or the cardiologist) may actually have to put them on vasodilators.

in fact the heart needs higher pressures to get good perfusion...

 

[Noyac]

This is a dangerous statement in my opinion.