What complication should be monitored closely in older patients with aortic stenosis during exertion?

In older patients with aortic stenosis, exertional dyspnea is a significant complication that requires close monitoring. This condition arises because aortic stenosis restricts blood flow from the heart, leading to increased pressure in the heart's chambers and reduced cardiac output, particularly during physical activity. As patients exert themselves, their demand for oxygen rises, and the compromised heart's ability to meet this demand can result in difficulty breathing, or dyspnea.

Exertional dyspnea indicates that the heart is struggling to pump effectively under increased physical stress, which can lead to serious outcomes if not addressed. It's an important symptom that reflects the severity of the aortic stenosis and the impact it has on the patient's activity level and quality of life. Monitoring for this complication is crucial because it can signal an acute deterioration in the patient's condition, such as heart failure or the need for surgical intervention.

While chest pain, palpitations, and dizziness can also be relevant symptoms, exertional dyspnea is a more direct indicator of the limitations placed on the cardiovascular system due to aortic stenosis during physical activity in older adults. This focus allows healthcare providers to appropriately gauge risk and initiate timely interventions to manage the condition effectively.