Critical aortic stenosis (AS) is the single most problematic valvular disease we encounter in the ICU. Patients with critical AS have a fixed cardiac output and cannot meaningfully increase cardiac output to meet the physiologic demands of critical illness. In this article, we present the case of a 53-year-old man with severe AS and pulmonary hypertension who developed hypotension during waiting for an elective aortic valve replacement. We discuss practical considerations and emergent treatment for the hemodynamically unstable patient with critical AS. |
