It’s been shown in angiographic studies in patients with aortic stenosis that the direction of flow can reverse in the large coronary arteries during the ejection phase of systole. This means that instead of the blood flowing from the coronaries to the heart wall, it gets ejected into the aorta!

That coupled with the increased demand of the heart muscle for oxygen, lead to the tendency for AS patients to experience chest pain.

And yes, it may be lethal even! It just reiterates that angina pectoris (anterior chest pain associated with inadequate oxygenation to the heart muscle) should never be taken lightly.