Aortic stenosis: Hypotension Rx

Clinical - Cardiovascular

In hypotensive patients with aortic stenosis,Phenylephrine is the vasopressor choice. “The rationale is 3-fold: (a) if left ventricular (LV) afterload is relatively fixed by the stenotic valve, increasing peripheral vascular resistance will have less of an effect on myocardial work than it would on an “unloaded” left ventricle; (b) increases in diastolic blood pressure will presumably increase CPP, and thus myocardial DO2; and (c) reflexive bradycardia reduces myocardial consumption of oxygen (VO2).”


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