Special anaesthesia: aortic stenosis: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Special anaesthesia: aortic stenosis

Sample item

Which haemodynamic goal is appropriate for a patient with severe aortic stenosis undergoing non-cardiac surgery?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Maintain sinus rhythm, preload, afterload and avoid tachycardia

The fixed outflow obstruction requires adequate coronary perfusion pressure, so systemic vascular resistance and preload must be maintained and tachycardia avoided. Phenylephrine is a suitable vasopressor, and spinal anaesthesia is generally avoided.

Option by option

  • A. Reduce afterload and increase heart rate

    Falling afterload and tachycardia cause ischaemia.

  • B. Maintain sinus rhythm, preload, afterload and avoid tachycardia (correct)

    Correct. Preserve preload, afterload and rate control.

  • C. Give large doses of vasodilators

    Vasodilators are dangerous.

  • D. Allow hypotension

    Hypotension decreases coronary perfusion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Maintain sinus rhythm, preload, afterload and avoid tachycardia. The fixed outflow obstruction requires adequate coronary perfusion pressure, so systemic vascular resistance and preload must be maintained and tachycardia avoided.

Why is "Reduce afterload and increase heart rate" not the answer?

Falling afterload and tachycardia cause ischaemia.

Why is "Give large doses of vasodilators" not the answer?

Vasodilators are dangerous.

Why is "Allow hypotension" not the answer?

Hypotension decreases coronary perfusion.

What concept does this question test?

It tests Special anaesthesia: aortic stenosis in Anaesthesia. Phenylephrine is a suitable vasopressor, and spinal anaesthesia is generally avoided.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Special anaesthesia: aortic stenosis?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.