What clinical presentation is associated with critical aortic stenosis?

Critical aortic stenosis is a significant narrowing of the aortic valve that impedes blood flow from the left ventricle to the aorta. When this condition is critical, it leads to a range of serious cardiovascular problems, primarily due to the heart's inability to effectively pump blood to the systemic circulation.

Profound congestive heart failure is a hallmark presentation because the left ventricle becomes severely overloaded as it attempts to overcome the obstruction. This excess workload can lead to ventricular hypertrophy, and ultimately, if the condition is not managed promptly, it results in the heart's inability to maintain adequate perfusion, leading to symptoms such as tachycardia, difficulty feeding, lethargy, and respiratory distress in neonates. The child may also present with signs of systemic hypoperfusion, such as poor perfusion, cool extremities, and reduced urine output.

Severe hypertension, mild cyanosis, and normal blood pressure do not accurately reflect the critical state associated with aortic stenosis. Instead, profound congestive heart failure directly relates to the compromised hemodynamics resulting from the critical obstruction. Understanding this condition's systemic effects is vital for providing appropriate care and intervention in neonates with aortic stenosis.