Aortic Valve Stenosis

Symptoms | Treatments

What is

Symptoms

Causes and Risk Factors

Diagnosis

Treatment

What is - Aortic Valve Stenosis

Aortic valve stenosis (also known as aortic stenosis) is a narrowing of the heart's aortic valve. Stenosis occurs when the valve leaflets thicken, stiffen or fuse, due to cholesterol and calcium deposits in the valve. This causes the valve opening to narrow. Consequently, the aortic valve is unable to open properly, blocking blood flow from the heart into the aorta and onwards to the rest of the body.

An obstruction of the aortic valve will cause the heart to work harder in pumping blood to the body. As a result, the amount of blood which is pumped is limited, and the extra work burden weakens the heart muscle.

Symptoms of Aortic Valve Stenosis

In the early stages, patients with severe aortic stenosis may have no symptoms. However, as the disease progresses, classical symptomatic of breathlessness on exertion, chest pain and syncope may be a sign of more sinister prognosis.

The typical symptoms for aortic valve stenosis include:

Shortness of breath, especially with exertion or when you lie down
Fatigue
Dizziness or fainting
Sensations of a rapid, fluttering heartbeat (heart palpitations)
Chest discomfort or pain

Aortic valve stenosis often does not show any symptoms, making early detection difficult. Some signs and symptoms may only show up after a doctor’s physical examination. These signs include:

Heart murmur

Irregular heart rhythms (arrhythmias)

Aortic Valve Stenosis - Causes and Risk Factors

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.

Diagnosis of Aortic Valve Stenosis

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.

Treatment for Aortic Valve Stenosis

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.