A 63 year old man present with a triad of angina, syncope and congestive hea failure. Which of the following valvular hea lesion can be suspected :

Answer is C (Aoic stenosis) `Angina pectoris, Exeional syncope, and dyspnea (LV failure) represent the charactristic clinical triad of Aoic stenosis.' `Patients present with LV failure, angina pectoris or syncope all occurring with exeion.' Symptoms of Aoic Stenosis DyspneaQ Angina Pectoris') Syncope (Exeional)Q * Results primarily from elevation of * Resultsfrom imbalance between Syncope occurs due to stimulation of pulmonary capillary pressure secondary - increased myocardial oxygen reflex baroceptors. to LV failure requirement from increased myocardial With exeion, the LV pressure rise LVF and RVF may occur independently mass and intraventricular pressure (and) stimulating these baroceptors to or together as 'congestive cardiac - reduced oxygen availability peripherally vasodilate. failure'. Aoic stenosis leads to This results in an attempt to fuher chronic excessive after load and results increase cardiac output. Syncope occurs in LVF followed by RVF, thus when the stenotic valve does not allow an presenting as CCF adequate increase in cardiac output and systemic BF' falls. Sudden Cardiac Death is the fouh cardinal feature of Valvular Aoic Stenosis Aoic Stenosis is the most common valvular disease associated with sudden death.