What is the recommended approach regarding exertion for patients with aortic stenosis before surgery?

• A. They should avoid exertion.
• B. They should rest and avoid exertion before surgery.
• C. They should perform high-intensity workouts daily.
• D. Exercise has no impact.

Answer: (B)

In aortic stenosis, the narrowed valve creates a fixed stroke volume, so the heart can’t adequately increase output during activity. Exertion raises heart rate and contractility, but because the outflow is limited, diastolic filling time and coronary perfusion suffer, increasing the risk of syncope, angina, or heart failure. Because of this, the safest approach before surgery is to rest and avoid exertion to keep hemodynamics stable until the valve can be addressed. High-intensity workouts would add stress and are not appropriate, and saying exercise has no impact isn’t accurate since activity directly affects the compromised circulation in aortic stenosis.