What does a narrowed pulse pressure indicate in a patient with aortic stenosis?

A narrowed pulse pressure in the context of aortic stenosis indicates an obstruction of blood flow. In aortic stenosis, the aortic valve becomes narrowed, leading to increased resistance during the ejection of blood from the left ventricle into the aorta. This results in a lower systolic blood pressure due to the limited amount of blood being ejected and reduced stroke volume, and a relatively high diastolic blood pressure due to increased vascular resistance and less blood being able to move forward effectively.

The pulse pressure, defined as the difference between systolic and diastolic blood pressures, becomes narrower because the systolic pressure drops while diastolic pressure remains higher due to the resistance. This narrowing is indicative of the impaired cardiac output associated with the mechanical obstruction from the stenotic valve, demonstrating that the heart is working harder to eject blood against this increased pressure gradient.

In contrast, an increased stroke volume would lead to a wider pulse pressure, severe aortic regurgitation would typically present with a widened pulse pressure, and normal cardiac function would not exhibit a narrowed pulse pressure as there would be efficient blood flow through the aorta. Therefore, the presence of a narrowed pulse pressure is a key clinical sign that reflects the hemodynamic alterations caused