7. What is the classic triad of symptoms in aortic valve stenosis and how do they predict mortality if the patient remains untreated?
The classic triad of symptoms in patients with aortic stenosis is exertional angina, exertional syncope and dyspnea from congestive heart failure.
The development of aortic stenosis takes many years and is initially asymptomatic. Dyspnea is the first symptom of aortic stenosis in about 50% of the cases while syncope and angina account for 35% and 15% of initial symptoms respectively.
The clinical significance of a patient with AS exhibiting symptoms cannot be underemphasized since the onset of symptoms is accompanied by a dramatic increase in mortality. According to one large series, if aortic valve replacement is not performed, patients presenting with dyspnea have a mean life expectancy of 2 years, those with syncope 3 years, and presenting with angina have an average of 5 years.