Registered Cardiovascular Invasive Specialist (RCIS) Practice Test

Which of the following is an important consideration for patients with aortic stenosis undergoing surgery?

1. They require high fluid volumes

2. They may have bradycardia

3. They commonly have hypertension

4. They benefit from high doses of vasopressors

The correct answer is: They may have bradycardia

Patients with aortic stenosis often experience significant cardiovascular changes due to the narrowing of the aortic valve. This condition can lead to several issues including diminished cardiac output and altered heart rate responses. One common arrhythmia associated with aortic stenosis is bradycardia, especially during surgical procedures where anesthesia and the surgical stress response can further impact heart rate. Bradycardia in these patients occurs because their heart is often trying to cope with the increased pressure gradients and afterload presented by the stenosis. Additionally, the autonomic regulation of heart rate can be compromised, leading to a propensity for slower heart rates during times of stress, such as surgery. Understanding that they may have bradycardia allows clinicians to monitor cardiovascular stability closely and take action if heart rates drop too low, which can worsen hemodynamics in an already compromised cardiac state. This consideration is critical for ensuring patient safety and optimizing surgical outcomes. In contrast, the other considerations do not align as closely with the typical pathophysiology of aortic stenosis patients. High fluid volumes can pose a risk due to volume overload; common hypertension may not be a universal characteristic in these patients; and while vasopressors can be necessary in some scenarios, aortic stenosis