Question

Why can nitroglycerin worsen chest pain in patients with aortic valve stenosis? My best guess is that it can cause hypotension and the heart would start beating faster to put out more blood which would increase the myocardial oxygen demand but I don't know if that is correct.

Answer 1

In aortic stenosis there is insufficient flow of blood from heart to aorta because of valve stenosis which can exert extra pressure on the heart to pump blood . And if in this situation we give the patient nitroglycerin .that will cause hypotension in patient by vasodilation o in peripheral blood vessels which decrease the preload and increase contractibility of heart (without any change in the cardiac from nitroglycerin ) , this can leads in the decrease in perfusion capacity of heart tissue a , hence can result in angina .

So nitroglycerin should not be given to patient of aortic valve stenosis .