Changes in blood pressure in children with valvular aortic stenosis in bicycle ergometer stress

: Children with aortic stenosis (n = 25) show a lower systolic blood pressure elevation during exercise than normal subjects (n = 47). The post-exercise systolic blood pressure minus the pre-exercise systolic pressure was calculated in both groups (23.60 +/- 10.8 mm Hg versus 47.23 +/- 14.9 mm Hg). There is no significant correlation between pressure response during exercise and the pull back gradient during heart catheterization. But if the difference between post-exercise systolic pressure and pre-exercise pressure is greater than 25 mm Hg there is a very low probability of a pull back gradient greater than 50 mm Hg. We conclude that exercise testing may be helpful in selecting those patients with aortic stenosis for catheterization who are likely to require surgery.