Aortic stenosis is a heart disorder that causes the aortic valve to narrow. The aortic valve is placed between the left ventricle (the heart’s main pumping chamber) and the aorta (the body’s biggest artery). It serves as a one-way valve, allowing blood to flow from the heart to the rest of the body while preventing backward flow. 

Aortic stenosis occurs when the aortic valve stiffens and narrows, reducing blood flow from the left ventricle to the aorta. This narrowing can occur due to various reasons, including age-related calcium deposits, congenital heart defects, rheumatic fever, or other underlying conditions.

Aortic stenosis causes the heart to work harder to pump blood through the narrowed valve, resulting in increased pressure within the left ventricle. Over time, this can cause the heart muscle to thicken and weaken and may result in symptoms such as chest pain, shortness of breath, fatigue, fainting, and heart palpitations.

Underlying Reasons Behind Aortic Stenosis

  • Age-related calcification: Calcium deposits on the aortic valve will accumulate with age, which will make it to stiffen and narrow. This is the most common cause of aortic stenosis in elderly people.
  • Congenital heart defects: Some people are born with abnormal aortic valves that are already narrowed or malformed. This condition can cause aortic stenosis. It has possibility of happening at birth or develop later in adulthood.
  • Rheumatic fever: Rheumatic fever is caused by untreated or improperly treated strep throat or scarlet fever. It can damage heart valves, especially the aortic valve. Overt time, aortic stenosis can develop as a result of this injury.
  • Bicuspid Aortic Valve: Normally, the aortic valve has three leaflets or cusps. In some individuals, the valve has only two cusps, known as a bicuspid valve. This congenital abnormality can lead to the development of aortic stenosis later in life.
  • Other heart conditions: Certain heart conditions, such as aortic valve thickening (sclerosis) or aortic valve regurgitation (leaking), can increase the risk of developing aortic stenosis.

Warning Signs of Aortic Stenosis

In cases of mild-to-moderate aortic stenosis, symptoms may not be present. However, typical symptoms of aortic stenosis include

1.Breathlessness or respiratory challenges:

  •  Shortness of breath or difficulty breathing
  • Labored breathing or respiratory distress

2. Profound fatigue or excessive tiredness:

  • Feeling very tired or experiencing fatigue
  • Overwhelming weariness or extreme lack of energy

3. Dizziness or loss of consciousness:

  • Vertigo or lightheadedness
  • Fainting or episodes of syncope

4. Chest discomfort or pain:

  • Chest pain or angina
  • Precordial pain or thoracic discomfort

5. Rapid heart rate or irregular rhythm:

  • Fluttering sensation or palpitations
  • Rapid heartbeat or cardiac arrhythmia

Treatment Options

Fortunately, there are various treatment options for individuals with aortic stenosis. Suppose you have mild or moderate aortic stenosis. In that case, your doctor may recommend the following approaches:

  • Regular monitoring of the aortic valve: Periodic check-ups to ensure the stenosis does not worsen
  • Symptom management through medication: Prescription of medications to alleviate symptoms

In cases of severe aortic stenosis, valve replacement may be necessary. The method of valve replacement can vary based on the patient’s condition and other factors:

  • Surgical Aortic Valve Replacement (SAVR): Valve replacement performed through surgery
  • Transcatheter Aortic Valve Replacement (TAVR): Valve replacement is conducted via cardiac catheterization, depending on the patient’s condition and other factors.

Valve Replacement

Valve replacement serves as a viable treatment choice for numerous individuals diagnosed with aortic stenosis. By replacing a diseased valve, patients can experience a reduction or even elimination of symptoms. It is often reported that valve replacement brings about a remarkable restoration of their quality of life. The procedure involves replacing the impaired valve with a new valve, typically made of mechanical or tissue materials. This can be accomplished through either traditional heart surgery or a transcatheter aortic valve replacement (TAVR) procedure.

TAVR (Transcatheter Aortic Valve Replacement)

In recent times, TAVR has emerged as a viable alternative to traditional heart surgery for numerous patients. During a TAVR procedure, a catheter—a long tube—containing a collapsible valve is inserted into an artery, typically in the groin. The new valve is then positioned within the existing aortic valve and expanded, displacing the old and diseased valve leaflets. The absence of surgery in TAVR results in several advantages, including

  • Shorter hospital stay compared to traditional surgery.
  • Reduced risk of infection.
  • Quicker recovery period.

While TAVR presents a favorable option, it’s important to note that like any medical procedure, there are associated risks, such as infection, bleeding, and stroke. However, advancements have led to the development of cerebral embolic protection devices designed to capture debris during the TAVR procedure. This innovation aims to potentially decrease the risk of stroke.

Key Questions to Ask Your Doctor

  1. How would you classify the severity of my aortic stenosis?
  2. What potential consequences could arise if I choose not to pursue any treatment? Is it safe to wait?
  3. Are there any methods for monitoring my aortic stenosis at home? How can I keep track of its progression?
  4. Are there specific modifications I should consider making to my diet and exercise routines in order to manage aortic stenosis effectively?
  5. Are there medications available that can help alleviate my symptoms and enhance my well-being?
  6. What are the treatment options available to me? Could you explain the risks and benefits associated with each option?
  7. Can you provide information on the success rates for the recommended procedure or treatment?
  8. How long is the estimated recovery time for each treatment option?
  9. Who is the most qualified professional to perform the procedure or surgery?
  10. When should I contact you or seek medical attention after the procedure or treatment?

Important Facts to Know

  • The primary cause of aortic stenosis is calcification, characterized by the formation of calcium deposits on the aortic valve.
  • The risk of developing aortic stenosis generally increases with age.
  • Risk factors for aortic stenosis include a family history of heart valve disease, hypertension (high blood pressure), high cholesterol levels, the presence of a congenital heart defect known as a bicuspid aortic valve (where there are only two valve leaflets), a history of rheumatic fever, smoking, and diabetes.
  • Individuals with severe and symptomatic aortic stenosis typically require valve replacement. This can be achieved through either traditional surgical intervention or, if the patient meets the necessary criteria, via cardiac catheterization.