Aortic Stenosis - Causes, Symptoms & Treatment

Aortic stenosis is the abnormal narrowing of the aortic valve, which restricts the flow of blood from the ventricle into the aorta. Normally, blood passes from the left lower chamber of the heart, called the left ventricle, through the aortic valve into the main artery of the body, the aorta. If the aortic valve should become stenosed or narrowed, the blood flow through it is reduced and the heart has to work harder to pump blood to the body.

Eventually your heart muscle becomes thicker because it has to pump harder due to the obstruction. In addition, your heart can pump only a limited amount of blood and can't provide the increase in blood flow you need for activities such as exercise. Several factors, including aging, can damage the aortic valve and lead to aortic valve stenosis. Some babies are even born with a defective aortic valve. If you have severe aortic valve stenosis, you'll usually need surgery to replace the valve. Left unchecked, aortic valve stenosis can lead to serious heart problems.

Stenosis means narrowing. Aortic stenosis is then a narrowing of the aortic valve or a narrowing of the aorta directly above (supravalvar) or below (subvalvar) the aortic valve. Normally, blood carrying oxygen (oxygenated) enters the left upper chamber (atrium) of the heart. It is then pumped into the lower left chamber (ventricle). The aortic valve opens when the heart contracts to pump blood from the left ventricle into the aorta, the body's main artery. When the left ventricle relaxes, the aortic valve closes because there is a higher blood pressure within the aorta compared to the ventricle.

In aortic stenosis, the wall of the left ventricle usually thickens because the ventricle must work harder to pump blood through the narrowed valve opening into the aorta. The thickened heart muscle requires an increasing supply of blood from the coronary arteries, and sometimes, especially during exercise, the blood supply does not meet the needs of the heart muscle, and chest pain, fainting, and sometimes sudden death may occur. The heart muscle may also begin to weaken, leading to heart failure. The abnormal aortic valve can rarely become infected by bacteria (infective endocarditis).

Causes of Aortic Stenosis

Find common causes and risk factors of Aortic Stenosis:

If you have aortic stenosis, you usually have disease of the cusps (or flaps) of the aortic valve. The most common cause of aortic stenosis is age-associated degeneration and calcification of the aortic valve, which often causes symptoms in elderly patients. In the past, this type of degeneration of the valve was most common in patients who had rheumatic fever during childhood. Currently, rheumatic fever is rarely a cause of aortic valve degeneration. About 1-2% of the population is born with only two valve leaflets and, for reasons not yet well understood, is at increased risk for developing aortic stenosis. These patients often develop symptoms between the ages of 40 and 60.

• A build-up of calcium can stiffen the aortic valve and interfere with its proper functioning. This is the most common cause of aortic stenosis in people aged 70 years and over.
• Some people are born with minor abnormalities of the aortic valve. Over time, these abnormalities may cause the valve to narrow.
• A condition that can scar the aortic valve and narrow its opening.

Signs and Symptoms of Aortic Stenosis

The symptoms usually include breathlessness, fainting episodes, and chest pain. In some cases, you may have palpitations or an abnormal heart rhythm such as atrial fibrillation. This may aggravate the symptoms of aortic stenosis. Aortic stenosis does not always cause symptoms immediately, even though the valve can be tight. When the heart begins to fail, symptoms of congestive heart failure can develop including fatigue, weakness, shortness of breath with exercise or at night, and swelling in the ankles. Other symptoms associated with aortic stenosis are angina (chest pain) and fainting upon exertion (syncope). Characteristic signs include a heart murmur heard with a stethoscope.

• Fainting , weakness , or dizziness with activity
• Dizziness
• Visual problems.
• Chest pain (angina) or tightness
• Heart murmur
• Shortness of breath, especially with exertion
• Breathlessness

Treatment for Aortic Stenosis

Treatment may include:

• Medications to prevent heart failure
• Surgery.
• Lifestyle patterns such as maintaining physical activity while avoiding hard physical exercise, control of weight and avoidance of smoking.