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Bicuspid Stenosis ↑ Left atrial ESV ↓ Left ventricular EDV ↑ Left atrial pressure (11) Left atrial hypertrophy Pulmonary hypertension ↓ Left ventricular filling ↑ Pulmonary hydrostatic pressure ↑ Afterload in right ventricle (7) Enlarged right ventricle ↓ Left ventricular preload (2) Orthopnea ↓ Left ventricular filling (5) Pulmonary edema ↓ Surface area for gas exchange ↓ Diffusion ↓ PO2 Hypoxia ↓ Stroke volume Bronchioconstriction (4) Wheezing ↑ PCO2 (3) Dyspnea (1) Shortness of breath (10) ↓ Blood pressure Hypercapnia ↓ Venous return (9) Tachycardia ↓ Cardiac output (8) ↑ Ventilation rate (6) Edema ↑ Heart rate