Q. How to investigate aortic stenosis by Exercise Testing?

Exercise testing is relatively contraindicated in patients with aortic stenosis. Its diagnostic accuracy to pick up additional coronary artery disease is limited in view of baseline ECG changes and left ventricular hypertrophy. Exercise testing should not be performed in symptomatic patients. It is safe to do in asymptomatic patients provided it is supervised by an experienced physician and ECG and blood pressure are closely monitored. While prognostic information of exercise induced ECG changes is uncertain-it can provide data about patient's exercise capacity and exercise induced hypotension. Limited exercise tolerance and/or exercise induced hypotension is an indication for aortic valve replacement in a patient with moderate to severe aortic stenosis.