What is Aortic Stenosis?

Aortic Stenosis (AS) is one of the most common valve disease problems, and can be one of the most serious. Approximately 1.5 million people in the U.S. suffer from AS, and one-third of those patients have a severe form of the disease. Hearing that you have been diagnosed with aortic stenosis can be scary, but many patients find comfort in understanding what it is and how to treat it.

Aortic stenosis occurs when the opening to the aortic valve narrows. This narrowing can cause reduced or blocked blood flow, forcing the heart to work harder and to become weakened. AS is most commonly caused by calcium build-up, but can also be caused by a congenital heart defect or rheumatic fever.

Aortic stenosis ranges in severity from mild to severe, and can be symptomatic or asymptomatic (meaning you may or may not experience symptoms). Your treatment depends on the severity of your condition. In some mild cases, regular check-ups to monitor the condition and your symptom status may suffice. Other options include a procedure or surgery to repair or replace the valve.

To help you understand more about aortic stenosis, read on to learn more about symptoms, causes, and treatment options.

Symptoms Associated with Aortic Stenosis:

  • Dizziness or feeling faint, or fainting with activity
  • Tightness or pain in the chest, especially during activity
  • Heart palpitations
  • Breathlessness
  • Increased fatigue with activity previously well tolerated

Causes:

Calcium Build-Up – Calcium is a normal mineral found in the blood stream. As the blood flows through the heart valves, calcium may deposit on the valves over time. With age, the deposits may increase which can cause a build-up on the valve. In some individuals, deposits may cause the cusps of the valve to harden reducing or blocking the blood flow. This issue is most common in people over the age of 70.

Congenital Heart Defect – The aortic valve has three cusps at its opening, which are triangle shaped pieces of tissue. The specific congenital heart defect is when the aortic valve doesn’t have the right number of cusps – most commonly, this defect results in only two cusps but there have been cases of only one or up to four cusps. Patients with this issue may require aortic valve replacement sooner in life.

Rheumatic Fever – Rheumatic fever is a bacterial infection that can develop if strep throat isn’t properly treated. This infection causes damage to the heart through swelling and can cause the cusps of the valves to stick together and narrow. Not all individuals who have had rheumatic fever will develop heart issues.

Treatments:

Surgical aortic valve replacement (SAVR)

SAVR is an open-heart surgery in which the heart is accessed through an incision made in the chest. The affected valve is removed and replaced while the heart is stopped and a heart-lung machine is used to continue blood flow. After the valve is replaced, the heart is restarted and the chest incision is closed. SAVR is considered a major surgery, and carries the risk of complications such as blood clots, bleeding, stroke, infection, and heart damage.

Transcathter aortic valve implantation (TAVI)

During a TAVI procedure, the aortic valve is replaced with an artificial valve delivered by a catheter – a small hollow tube that is inserted into blood vessels. This procedure is minimally invasive and doesn’t typically require open-heart surgery. Typically, the procedure time and recovery time for TAVI is shorter than SAVR. One of the main risks of transcatheter aortic valve replacement is stroke, which can occur if debris that breaks off during the procedure travels through the bloodstream and reaches the brain. If you are planning on having this procedure, you may be able to protect yourself from the risk of stroke by using an embolic protection device, which captures and removes the debris from the bloodstream.

If you believe you are experiencing symptoms of aortic stenosis, it is important that you discuss it with your doctor. Left untreated, aortic stenosis can progress and may lead to other heart issues and death.
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