Gender-specific Evaluation of Symptom Awareness in Female Versus Male Patients with Severe Aortic Stenosis

Background Aortic valve stenosis is a common valvular disease that increases with age and is associated with a poor prognosis when severe (1-3). Treatment options include surgical or interventional replacement of the aortic valve . Awareness of aortic valve stenosis in the general population is low (2% in Europe) (4). Auscultation as a simple screening tool is relatively underused. This leads to a clear underdiagnosis of aortic stenosis especially in patients with only minor or no complaints. In addition, several studies show a marked gender discrepancy: women tend to be diagnosed later, checked less regularly for asymptomatic vitium, and operated on or intervened later (5-7). One possible reason for this could be gender-specific symptom perception. For example, women perceive pain more variably, sensitively, and intensely than men and report more painful conditions. Related to a possible myocardial infarction, women show a greater number of additional, ostensibly nonbreast-related pain symptoms regardless of the presence of chest pain. Both female patients and practitioners are less likely to attribute their prodromal symptoms to heart disease compared with men. Women are generally at higher risk for affective disorders (e.g., depression, anxiety disorders) than men, with greater susceptibility varying with age (8-10).

Literature

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Inclusion criteria

• • Indication for surgical or interventional aortic valve replacement for aortic stenosis as consented by the local heart team

• Age> 18 years
• Patient is willing and able to complete the surveys in German language

Exclusion criteria

• • Additional procedures such as coronary bypass surgery, any surgery on another than the aortic valve, aortic surgery

• PCI performed within the last 30 days