Overview
Aortic valve stenosis is a type of heart valve disease that occurs when the valve between the lower left heart chamber and the body's main artery (aorta) becomes narrowed and doesn't open fully. This reduction in blood flow from the heart to the aorta and the rest of the body can lead to various symptoms, ranging from mild to severe. Symptoms may include an irregular heart sound (heart murmur), chest pain (angina), feeling faint or dizzy, or fainting with activity. Treatment for aortic stenosis depends on the severity of the condition and may involve surgery to repair or replace the valve. Without treatment, severe aortic valve stenosis can be life-threatening.
Understanding the disease
Symptoms
The symptoms of aortic stenosis may include an irregular heart sound (heart murmur) heard through a stethoscope, chest pain (angina) or tightness with activity, feeling faint or dizzy or fainting with activity, shortness of breath, especially with activity, fatigue, especially during times of increased activity, rapid, fluttering heartbeat (palpitations), not eating enough (mainly in children with aortic valve stenosis), not gaining enough weight (mainly in children with aortic valve stenosis), and heart failure symptoms such as fatigue, shortness of breath, and swollen ankles and feet. If you develop symptoms that may suggest aortic valve stenosis, you should make an appointment with your healthcare provider.
Risk Factors
The risk factors for developing aortic stenosis include smoking and other tobacco use, high blood pressure, high cholesterol, diabetes, obesity, a family history of early heart disease, lack of exercise, and atherosclerosis or the buildup of plaques in the arteries. Having a parent, brother, sister, or child with an aortic aneurysm also increases the risk of an aortic aneurysm and rupture. Genetic conditions such as Marfan syndrome, Loeys-Dietz syndrome, or vascular Ehlers-Danlos syndrome can significantly increase the risk of a thoracic aortic aneurysm.
Development
Aortic valve stenosis can develop in several ways:
- Congenital heart defect: Some children are born with an aortic valve that has only two cusps (bicuspid aortic valve) instead of three (tricuspid aortic valve). Rarely, an aortic valve may have one (unicuspid) or four (quadricuspid) cusps. Having a congenital heart defect such as a bicuspid aortic valve requires regular medical checkups. The valve condition may not cause any problems until adulthood. If the valve begins to narrow or leak, it may need to be repaired or replaced.
- Calcium buildup on the valve (aortic valve calcification): Calcium is a mineral found in the blood. As blood repeatedly flows over the aortic valve, calcium deposits can build up on the heart valves. In addition to these primary causes, aortic valve stenosis can also occur as a result of rheumatic fever, which is an autoimmune disorder that can damage heart valves. However, this is less common in recent times due to improved diagnosis and treatment of rheumatic fever. It's important to note that aortic valve stenosis can also develop as a result of aging, as calcium deposits can accumulate over time. In some cases, aortic valve stenosis can also be caused by an infection or inflammation of the heart, or other heart conditions such as hypertension or coronary artery disease. It's crucial to consult a healthcare professional for a proper evaluation and diagnosis of aortic valve stenosis, as the underlying cause can influence the appropriate course of treatment.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect aortic valve stenosis, especially if you experience symptoms such as an irregular heart sound (heart murmur), chest pain or tightness with activity, feeling faint or dizzy or fainting with activity, shortness of breath, rapid heartbeat, fatigue, not eating enough, or not gaining enough weight. It's essential to consult with your healthcare provider to determine the appropriate course of action and receive proper diagnosis and treatment.
Diagnosis
To diagnose aortic stenosis, your healthcare provider will likely perform a physical exam, listen to your heart with a stethoscope, and ask questions about your symptoms and medical history. They may also order several tests, including an echocardiogram, exercise tests or stress tests, cardiac CT scan, or cardiac MRI scan. An echocardiogram is often the first test used to diagnose aortic stenosis, as it can provide detailed images of the heart and aortic valve, and help determine the severity of the condition.
Management and Treatment
Complications
Possible complications of aortic stenosis include:
- High blood pressure
- Kidney failure, requiring treatment with dialysis or a kidney transplant
- Fluid retention in your legs, causing swollen ankles or feet
- Shortness of breath due to a sudden buildup of fluid in the lungs
Prevention
Aortic valve stenosis can be prevented to some extent by taking steps to prevent rheumatic fever, keeping the heart healthy, and taking care of teeth and gums. It's important to consult with a healthcare provider for personalized advice and management of risk factors.
Home Remedies
It is important to consult with a healthcare provider for proper diagnosis and treatment of aortic stenosis. They can provide guidance on managing symptoms and recommend appropriate treatment options, which may include lifestyle changes, medications, or surgery.
Treatment
Treatment for aortic valve stenosis depends on the severity of the condition. Mild cases may not require treatment, while moderate to severe cases may require surgery to repair or replace the valve. Surgical options include aortic valve replacement or aortic valve repair. In some cases, a catheter-based procedure called transcatheter aortic valve replacement (TAVR) may be an option.
Preparing for medical consultation
To prepare for an appointment for aortic stenosis, you should:
- Find a medical center with a multidisciplinary heart valve team, including cardiologists and other care providers experienced in evaluating and treating heart valve disease.
- Be aware of any pre-appointment restrictions and ask about them when you schedule the appointment.
- Write down your symptoms, including any that may seem unrelated to heart valve disease.
- Note down key personal information, such as a family history of heart disease and any major stresses or recent life changes.
- Make a list of all medications, vitamins, and supplements you take.
- Consider bringing a family member or friend to the appointment for support and to help remember information.
- Prepare questions to ask your healthcare provider, such as the cause of your symptoms, recommended tests, and available treatments. Remember to discuss your concerns, symptoms, and medical history openly with your healthcare provider to ensure accurate evaluation and appropriate treatment.