Some patients notice fatigue rather than breathlessness or chest pain during or after exercise.  

People with valve disease – particularly aortic stenosis – tend to slow down or limit their activity to avoid getting chest tightness or breathlessness.  A reduction in exercise capacity can therefore be the first symptom.  This is often put down to aging and dismissed by patients. If a friend or relative notices a change and you don’t, encourage them to attend your next clinic appointment with you.

Fatigue and slowing down are a difficult call because they can also be caused by numerous conditions. Lack of fitness, painful or stiff joints, weight-gain, working too hard, anxiety, poor sleep or any general illness including colds and flus could all be reasons for doing less.  

An obvious change which is progressive rather than getting better could be significant.

Fatigue/slowing/reduction in exercise ability is particularly important once you know that you have severe valve disease because it is usually the first sign of trouble and means that breathlessness or chest tightness are likely to develop in the near future.