Aggravation of symptoms of angina in a patient when given nitrates is seen in-: (A) Aoic regurgitation, (B) Mitral regurgitation, (C) Single left coronary aery stenosis, (D) Idiopathic hyperophic subaoic stenosis
Answer is D. In subaoic stenosis, if vasodilators are given, it reduces the afterload, hence increasing the pressure gradient between the LV and aoa. This increases the ejection murmur. Ref Davidson 23rd edition pg 441