Aortic Stenosis
The aorta is the large artery that originates in the left ventricle (lower chamber) of the heart. Aortic stenosis is the narrowing or obstruction of the heart's aortic valve, which prevents it from opening properly and blocks the flow of blood from the left ventricle to the aorta.
Causes, incidence, and risk factors:
As the aortic valve becomes more narrow, the pressure increases inside the left heart ventricle. This causes the left heart ventricle to become thicker, which decreases blood flow and can lead to chest pain. As the pressure continues to increase, blood may back up into the lungs and you may feel short of breath. Severe forms of aortic stenosis prevent enough blood from reaching the brain and rest of the body. Lightheadedness and fainting can result.
Aortic stenosis may be present from birth (congenital), or it may develop later in life (acquired). It is caused by many disorders. One common cause is rheumatic fever, a complication of untreated strep throat. Calcification of the valve can also cause this condition. In this case, the condition is usually not seen until a person reaches their 70s.
Aortic stenosis occurs in approximately 5 out of every 10,000 people. It is more common among men.
Symptoms
- Fainting, weakness, or dizziness with activity
- Breathlessness with activity
- Sensation of feeling the heart beat (palpitations)
- Under the chest bone, may move to other areas
- Crushing, squeezing, pressure, tightness
- Pain increases with exercise, relieved with rest.
If there are no symptoms or symptoms are mild, you may only need to be monitored by a health care provider. If symptoms are moderate to severe, you may need to stay in the hospital.
Medications can include diuretics, digoxin, and other medications to control heart failure. Symptomatic people may be advised to avoid strenuous physical activity. People with symptoms of aortic stenosis (difficulty breathing, chest pain, fainting episodes) should have a physical exam every 6 to 12 months and an ECG performed every 1 to 3 years.
Surgery to repair or replace the valve is the preferred treatment for patients who have symptoms. Some high-risk patients are poor candidates for heart valve surgery. A less invasive procedure called balloon valvuloplasty may be done instead. This is a procedure in which a balloon is placed into an artery in the groin, advanced to the heart, placed across the valve, and inflated. This may relieve the obstruction caused by the narrowed valve.
Credit: National Institute of Health.