Aortic Stenosis

What is Aortic Stenosis?

Aortic stenosis occurs when the aortic valve, responsible for regulating blood flow from the left ventricle to the aorta, becomes narrowed. This restricts the amount of oxygen-rich blood that reaches the body and forces the heart to work harder to pump blood through the narrowed valve.

Over time, this increased workload can lead to complications such as heart failure, arrhythmias, and even sudden cardiac death in severe cases. Aortic stenosis can develop gradually due to age-related degeneration, or it can be congenital (present from birth).

Causes and Risk Factors

Aortic stenosis is caused by various factors that affect the structure and function of the aortic valve. These include:

• Age-Related Calcification: The most common cause, calcium deposits build up on the valve over time, leading to stiffness and narrowing.
• Congenital Heart Defects: Some individuals are born with a bicuspid aortic valve (two leaflets instead of three), making them more prone to stenosis.
• Rheumatic Fever: A complication of untreated strep throat, this inflammatory condition can cause scarring and narrowing of the aortic valve.
• Chronic Kidney Disease: Patients with kidney disease are at higher risk of developing calcification and stiffening of the aortic valve.
• High Blood Pressure & High Cholesterol: These conditions can contribute to plaque buildup and increased strain on the valve.

Other risk factors include smoking, obesity, diabetes, and a family history of heart valve disease. Managing these risks can help slow the progression of aortic stenosis.

Symptoms of Aortic Stenosis

Symptoms of aortic stenosis often develop gradually and may not be noticeable in the early stages. As the condition progresses, common symptoms include:

• Chest Pain (Angina): Discomfort or tightness in the chest, especially during physical activity.
• Shortness of Breath: Difficulty breathing, particularly with exertion or when lying down.
• Fainting or Dizziness: Reduced blood flow to the brain can cause lightheadedness or sudden fainting.
• Fatigue: Increased effort by the heart can lead to excessive tiredness.
• Heart Palpitations: Sensation of an irregular or rapid heartbeat.

If left untreated, aortic stenosis can lead to severe heart failure or sudden cardiac arrest. It is crucial to seek medical evaluation if any of these symptoms occur.

Diagnosis of Aortic Stenosis

Diagnosis involves a combination of clinical evaluation and diagnostic tests, including:

• Physical Examination: A doctor may detect a heart murmur using a stethoscope.
• Echocardiogram: Ultrasound imaging provides a detailed view of valve function and blood flow.
• Electrocardiogram (ECG): Identifies electrical abnormalities in the heart.
• Chest X-ray: Helps assess heart size and detect any lung congestion.
• Cardiac MRI: Offers detailed imaging to evaluate valve structure.
• Cardiac Catheterization: Measures blood pressure and oxygen levels in the heart chambers.

Treatment and Management

Treatment for aortic stenosis depends on the severity of the condition. Management strategies include:

• Regular Monitoring: Mild cases may only require periodic check-ups with echocardiograms.
• Medications: While they cannot cure stenosis, they help manage symptoms and prevent complications:
  • Beta-Blockers: Help regulate heart rate and reduce strain on the heart.
  • Diuretics: Reduce fluid retention and prevent swelling.
  • Blood Pressure Medications: Help maintain optimal circulation.
• Aortic Valve Replacement: The primary treatment for severe cases:
  • Surgical Aortic Valve Replacement (SAVR): Open-heart surgery to replace the diseased valve with a mechanical or biological valve.
  • Transcatheter Aortic Valve Replacement (TAVR): A minimally invasive procedure for high-risk patients.
• Lifestyle Modifications:
  • Regular cardiovascular exercise (as recommended by a doctor).
  • Heart-healthy diet rich in vegetables, whole grains, and lean proteins.
  • Smoking cessation and limited alcohol intake.

Living with Aortic Stenosis

With proper treatment and lifestyle adjustments, individuals with aortic stenosis can maintain a good quality of life. Regular medical follow-ups and adherence to prescribed treatments are essential for preventing complications.