The drugs that should be avoided or used with extreme caution in aortic stenosis are vasodilators, calcium channel blockers, diuretics, PDE-6 Inhibitors, Pure Alpha-1 Adrenergic Agonists, Beta-Blockers and NSAIDs.
NSAIDs should be avoided in people with aortic stenosis, as they can cause fluid retention and increase the workload of your heart.
Beta-Blockers, while sometimes used in people with aortic stenosis, the beta blockers must be avoided or used with extreme caution in people with aortic stenosis, if the person has co-existing, severe aortic regurgitation, as they can worsen the volume overload.
Pure Alpha-1 Adrenergic Agonists, like phenylephrine can cause a double load effect, in which increased systemic vascular resistance reduces cardiac output in a fixed outflow, which makes it dangerous in perioperative scenarios, so it must be avoided or used with extreme caution by people with aortic stenosis.
PDE-5 Inhibitors like vardenafil, tadalafil and sildenafil can also cause severe hypotension when they are combined with other vasodilators, especially in people with severe aortic stenosis.
While diuretics are helpful for pulmonary congestion, excessive diuresis through use of diuretics can reduce preload, drastically, which can lead to decreased cardiac output in people with aortic stenosis.
Calcium channel blockers and Non-dihydropyridine CCBs, like verapamil and diltiazem, are also often discouraged in people with severe aortic stenosis, due to their negative inotropic "decreased contraction" effects.
And nitrates, like nitroglycerin, ACE inhibitors, "in severe cases" and ARBs can also cause severe hypotension as people with fixed obstruction cannot increased their cardiac output in response to their falling blood pressure, so they should be avoided in people with aortic stenosis.
The most common cause of death in aortic stenosis patients is heart failure.
Heart failure causes at least 25.7% of deaths in aortic stenosis patients, followed by infection, which causes around 13.0% of deaths in aortic stenosis patients and malignancy causes around 11.1% of deaths in aortic stenosis patients.
Infection is the most common non cardiac cause of death in aortic stenosis patients, while heart failure is the most common cause of death in aortic patients, especially for sudden death.
The reason why you can't fly with aortic stenosis is mainly a result of high altitude reduced cabin pressure, which lowers your oxygen levels and can lead to hypoxia and also due to it straining your heart.
Flying with a aortic stenosis can potentially lead to heart failure, arrhythmia or even ischemia.
Although sometimes mild asymptomatic cases of aortic stenosis can sometimes be safe to fly with, by people with severe aortic stenosis, often will face risks of reduced oxygen, increased heart rate and dehydration, if they fly with aortic stenosis.
So as a result it can make it dangerous to travel by plane when you have aortic stenosis, especially severe aortic stenosis.
Airplane cabins are pressured to altitudes of 8,000 to 10,000 feet, in which thinner air reduces your blood oxygen levels.
The narrowed valve of people with aortic stenosis, already restricts their blood flow, and the decreased oxygen also forces your heart to work harder.
And your heart when you have severe aortic stenosis, "which is a stiff, narrowed valve" cannot increase it's output to be able to compensate for the lower oxygen, which leads to dizziness, fatigue and or fainting.
And the stress and the physiological changes that are caused by reduced oxygen, at high altitudes also can cause myocardial ischemia "lack of blood to your heart muscle", in people with severe aortic stenosis.
Also the dry, air that is also pressurized in the cabin of the airplane, can cause dehydration, and long periods of immobility also increases the risks of blood clots, which are also dangerous, for people with already weakened heart function.
Before you decide to fly on an airplane, you should consult with your doctor, to ensure that it's safe for you to do so.
People that have severe symptoms of aortic stenosis, like dizziness, severe chest pain or fainting are usually advised to not fly and seek out alternative travel.
And some people with severe, but stable, Aortic Stenosis, may also require supplemental oxygen, when flying, which can be arranged through the airline as well.