What is the primary symptom of aortic stenosis?

The primary symptom of aortic stenosis is exertional dyspnea during physical activity. This symptom arises because aortic stenosis leads to obstruction of blood flow from the heart to the aorta, particularly during increased physical demand when the heart has to pump harder. As the left ventricle works to overcome the obstruction, it can lead to decreased cardiac output and an inadequate supply of oxygenated blood to meet the body's needs during exertion. This results in shortness of breath, or dyspnea, that typically occurs during activities such as walking, climbing stairs, or exercising.

The other symptoms associated with aortic stenosis can include chest pain (often occurring with exertion), lightheadedness or syncope due to reduced cardiac output during physical stress, and heart failure symptoms like fatigue or edema, but exertional dyspnea is a hallmark symptom. Frequent coughing is less specific and not typically associated with aortic stenosis.