Aortic Stenosis Overview

Aortic Stenosis: A Narrow Path to Heart Health

Aortic stenosis refers to a condition where the aortic valve, a critical structure in the heart's circulation, becomes narrowed or obstructed. This limits blood flow from the heart's left ventricle into the aorta, the main artery that supplies oxygen-rich blood to the body's tissues.

Causes of Aortic Stenosis

The primary causes of aortic stenosis are:

1. Calcific aortic valve disease (CAVD): In this common form, calcium deposits build up on the valve's leaflets, causing them to stiffen and narrow. This is a gradual process that occurs with aging, affecting around 5% of individuals over 65 years old.
2. Congenital aortic stenosis: This type of aortic stenosis develops in people from birth due to abnormal development of the aortic valve or surrounding structures.
3. Rheumatic aortic stenosis: Caused by rheumatic fever, a complication of untreated streptococcal infections, this form is rare in developed countries but still prevalent in developing regions.
4. Aortic valve regurgitation (AR): In rare cases, aortic stenosis may occur following repair of aortic valve regurgitation, where the valve's repair procedure leads to a narrowed valve.

Symptoms of Aortic Stenosis

Often, aortic stenosis develops without causing symptoms due to its gradual onset. However, as the condition worsens, some individuals may experience:

1. Shortness of breath
2. Chest pain or angina
3. Palpitations
4. Fatigue
5. Lightheadedness or dizziness.

Diagnosis of Aortic Stenosis

Aortic stenosis is typically diagnosed using non-invasive tests and imaging studies. Common diagnostic methods include:

1. Echocardiography: A non-invasive ultrasound test that visualizes the heart's structure and function, providing accurate measurements of the aortic valve area and velocity of blood flow.
2. Exercise stress testing: To assess how the heart functions during physical activity, this test combines echocardiography and other monitoring devices.
3. Cardiac catheterization: This invasive procedure involves inserting a catheter into a blood vessel and into the heart to measure the pressure gradient across the aortic valve.
4. Computed tomography (CT) and magnetic resonance imaging (MRI): These imaging tests provide detailed visualizations of the heart and surrounding structures, helping to evaluate the severity and extent of the aortic stenosis.

Treatment of Aortic Stenosis

The primary goal of aortic stenosis treatment is to improve blood flow and prevent complications.

1. Medical management: In mild or asymptomatic cases, doctors may recommend medications to manage symptoms and stabilize the condition.
2. Valve repair or replacement: In severe or symptomatic cases, the aortic valve may need to be repaired or replaced. Surgical valve replacement, known as aortic valve replacement (AVR), is the most common treatment, while transcatheter aortic valve replacement (TAVR) is an alternative, minimally invasive option.
3. Balloon aortic valvuloplasty: In specific cases, such as those involving congenital aortic stenosis in children, balloon valvuloplasty may be performed to widen the aortic valve opening.

Complications of Aortic Stenosis

Untreated or poorly managed aortic stenosis may lead to several complications, including:

1. Heart failure: The heart must work harder to pump blood through the narrowed valve, eventually leading to heart failure.
2. Arrhythmias: Irregular heartbeats may develop as the heart tries to adapt to the reduced blood flow.
3. Syncope: Fainting may occur due to reduced blood flow to the brain.
4. Aortic dissection: Aortic stenosis may increase the risk of aortic dissection, a life-threatening condition where the aorta tears.
5. Endocarditis: Infectious endocarditis may develop as a result of bacterial infection and subsequent damage to the aortic valve.

Preventing aortic stenosis through lifestyle modifications, such as maintaining a healthy diet and exercising regularly, may help lower the risk of developing the condition. Early detection and prompt treatment of aortic stenosis are essential for improving patient outcomes.