Degenerative aortic stenosis increases in incidence with aging with patient presenting with symptomatic aortic stenosis above 80 years old. Congenital malformation of the aortic valve such as bicuspid aortic valve accelerates degeneration of the aortic valve and presents about 10 years earlier compared to normal trileaflet aortic valve. Less common risk factors include rheumatic heart disease, chronic renal failure and prior radiotherapy to the chest.
Aortic valve disease is diagnosed with the help of a physical examination. It can be picked up in its asymptomatic stage when an ejection systolic murmur is heard classically radiating to the carotid artery with a crescendo decrescendo manner best heard over the left sternal edge. Patients can present with symptoms and subsequently found to have a systolic murmur present. Your doctor will listen to your heart with a stethoscope for unusual sounds or a heart murmur before recommending further diagnostic tests, such as an echocardiogram or cardiac catheterisation.Transthoracic echocardiogram confirms the presence of aortic stenosis and assesses the severity as well as underlying cause of aortic stenosis. If the diagnosis is in doubt, invasive measurement of the aortic valve gradient can be measured with cardiac catheterisation.
Degenerative aortic stenosis is associated with aging. Unfortunately, no therapy has been proven to alter the rate of progression of aortic stenosis.Surgery can help repair or replace the aortic valve. Factors such as age, heart health and general state of health will determine the treatment procedure.Aortic valve repair: Surgery can be minimal or extensive depending on the valve problem.Aortic valve replacement: This can be done through conventional surgery or with a minimally invasive procedure, such as transcatheter aortic valve implantation, which is used to treat severe aortic stenosis. In this heart valve surgery, a balloon catheter is used to insert a tissue valve through a cut in the groin or chest.
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