Aortic Stenosis

Overview, Causes, & Risk Factors

Aortic stenosis is a narrowing of the opening of the aortic valve.The aortic valve is a flap-like opening located between the left side of theheart and the aorta. The aorta is the main artery carrying blood from theheart.

What is going on in the body?

The heart is divided into two halves, right and left. Each side has a pumpingchamber, called a ventricle. The left ventricle receives blood from the lungs.During a heartbeat, the left heart chamber squeezes, generating enough pressureto open the aortic valve. Blood from the left side is then pumped into theaorta and out into the body. When aortic stenosis has occurred, the opening ofthe valve is narrower than normal. This reduces the amount of blood flow to thebody.

What are the causes and risks of the condition?

The causes of aortic stenosis include:

  • calcium deposits that harden, or calcify, the valve
  • congenital heart disease from heart defects presentat birth
  • scarring of the valve from rheumatic heart disease
  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    Common symptoms of aortic stenosis include:

  • coughing atnight
  • fainting, especiallywith physical activity
  • fatigue
  • shortness of breaththat worsens at night or with exertion
  • visual impairments
  • The coronary arteries, which carry oxygen to heartmuscles, may be deprived of blood. That can cause heart pains called stableangina or unstable angina. This type of pain has been describedas a tightness, squeezing, or pressing sensation in the middle of the chest.The pain commonly extends into the left shoulder and down the arm.

    The severity of symptoms is not always related to the severity of the disease.In fact, people sometimes die suddenly from aortic stenosis without having hadsymptoms.

    Diagnosis & Tests

    How is the condition diagnosed?

    Diagnosis of aortic stenosis begins with a history and physicalexam. The healthcare provider also may do one or more of these tests:

  • cardiac catheterization
  • chestX-ray
  • echocardiogram with or without color Doppler studies
  • electrocardiogram (EKG)
  • Prevention & Expectations

    What can be done to prevent the condition?

    In many cases, nothing can prevent aortic stenosis. Proper treatment ofrheumatic fever with antibiotics can prevent damage to the aorticvalve.

    What are the long-term effects of the condition?

    As the aortic valve slowly narrows, it deprives body organs ofblood. Serious long-term effects may include:

  • congestive heart failure, a condition in which theweakened heart is unable to pump enough blood throughout the body
  • coronary heart disease
  • enlargement of the left ventricle, which cuts down the output of the heartstill more
  • pulmonary edema, orcongestion in the lungs
  • sudden death
  • What are the risks to others?

    Aortic stenosis is not contagious, and poses no risk toothers.

    Treatment & Monitoring

    What are the treatments for the condition?

    A goal of treatment is to allow the heart to get more blood into generalcirculation. Various medicines can help improve overall blood supply to thebody and the heart. They can also help reduce the person’s symptoms.

    In some cases, surgery is recommended to correct theaortic stenosis. Balloon valvuloplasty is a technique that lowers the pressureacross the valve by slightly enlarging the opening. This is usually done whensomeone is not stable enough for corrective surgery. More often, heart valve surgery is performed tocorrect the problem with the aortic valve.

    What are the side effects of the treatments?

    Medicines used to treat aortic stenosis can cause a variety of sideeffects. Surgery can cause bleeding, infection, or allergic reaction to anesthesia.

    What happens after treatment for the condition?

    Successful replacement of the valve restores normal blood flow. The long-termoutcome is usually very good. Artificial valves wear out over a period ofyears. Their function is monitored, and the valves are replaced as necessary.Some artificial valves require that the person take:

  • antibiotics before and after surgeries or dental work to avoid seriousheart infections
  • blood-thinning drugs to avoid blood clots, such as deep venousthrombosis
  • How is the condition monitored?

    An individual with aortic stenosis will have regular visits withthe healthcare provider. The provider may order regular electrocardiograms and echocardiograms to detect any signsof deterioration. Any new or worsening symptoms should be reported to theprovider.

    Article type: xmedgeneral