In Valvular Aoic Stenosis poorest prognosis in indicated when-

Aoic stenosis (AS or AoS) is the narrowing of the exit of the left ventricle of the hea (where the aoa begins), such that problems result. It may occur at the aoic valve as well as above and below this level.It typically gets worse over time. Symptoms often come on gradually with a decreased ability to exercise often occurring first If hea failure, loss of consciousness, or hea related chest pain occur due to AS the outcomes are worse.Loss of consciousness typically occurs with standing or exercise.Signs of hea failure include shoness of breath especially when lying down, at night, or with exercise, and swelling of the legs.Thickening of the valve without narrowing is known as aoic sclerosis It has poor prognosis when dyspnea occurs Ref Davidson 23rd edition pg 455