It is often preceded by an ejection click caused by the opening of the stenotic valve.

在此之前，经会出现瓣膜打开产生的喷射性喀喇音。

But remember the person who I said gets pain when they extend, usually an older person with a more arthritic or stenotic condition in their back.

但请记， 我提到的那位在伸展时感到疼痛的人，年纪较大且背部患有更严重关节炎或椎管症的患者。