Exercise testing in congenital aortic stenosis

Treadmill exercise testing was performed on 23 patients with isolated congenital aortic stenosis. It was found that eight patients, with a negative exercise test and a normal rise in systolic blood pressure on exercise, had gradients less than 45 mmHg. Fifteen patients with gradients greater than 50 mmHg had positive exercise tests and their systolic blood pressure did not rise normally. It is suggested that the left heart studies to measure aortic valve gradients can safely be postponed if an exercise test is negative. Serial exercise testing of such patients will give an indication when left heart catheterization should be considered.