What is Aortic Stenosis?
The aortic valve is located between the body's main artery (aorta) and the heart's left ventricle. When the ventricle contracts, the valve opens to allow blood to move into the aorta and through to the rest of the body. Aortic stenosis is a narrowing of the opening of the aortic valve. As this opening becomes smaller, blood has more difficulty flowing from the ventricle into the aorta.
What are the Risk Factors Associated with Aortic Stenosis?
Aortic stenosis is a condition which mainly affects older populations. While it may occur in those over the age of 60, it is most common to see symptoms around 70 or 80 years old. In addition to age, other factors which may influence the development of aortic stenosis include:
- Bicuspid Aortic Valve (BAV) - BAV is a common congenital (present from birth) defect which causes the aortic valve to be comprised of only 2 flaps, or cusps, instead of the normal three.
- Rheumatic Fever - This complication of strep throat can cause the development of scar tissue on heart valves, including the aortic valve, causing it to narrow.
- Chronic Health Conditions - Chronic health conditions known to contribute to cardiovascular troubles include diabetes, high blood pressure, and high cholesterol.
What are the Symptoms of Aortic Stenosis?
It takes time for symptoms of aortic stenosis to become apparent. In most cases, patients experience no symptoms at all until the narrowing begins to severely restrict blood flow. At that point, signs may include:
- Heart murmur
- Pain, pressure or tightness in the chest (angina)
- Fainting or feeling light-headed or dizzy with activity
- Fatigue with activity
- Heart palpitations, particularly a rapid or fluttering heart beat
What are the Complications of Aortic Stenosis?
As the heart works harder to pump blood despite the narrowed aortic valve, it can become weaker and lead to thickening of the ventricle wall. In time, this can lead to some serious health concerns. Among the complications which may impact patients are:
- Heart failure
- Blood clots
- Endocarditis (infection of the heart)
How is Aortic Stenosis Diagnosed?
For patients who are at risk for aortic stenosis or who are experiencing symptoms, a cardiologist may reach a diagnosis by conducting some of the following:
- Physical examination
- Medical history
- Electrocardiogram and/or stress test
- Imaging tests such as chest x-ray, cardiac MRI, or cardiac CT scan
- Cardiac catheterization
How is Aortic Stenosis Treated?
Based on the findings of the tests mentioned above, a cardiologist may recommend healthy lifestyle changes and ongoing monitoring of the condition. This is most likely if the condition is found to be less advanced and is causing few to no symptoms. However, in the event of more severe cases of aortic stenosis, surgery may be needed to repair or replace the diseased valve.
Transcatheter Aortic Valve Replacement (TAVR) for Aortic Stenosis
TAVR is a minimally invasive approach for valve replacement that was approved for the treatment of inoperable aortic stenosis in 2011, making it a likely option for many patients who are deemed too high-risk to undergo open heart surgery. During the procedure, the diseased valve is repaired without being removed. Similar to placing a stent, TAVR uses a catheter to place a fully collapsible transcatheter heart valve (THV) into the existing aortic valve. Then, the new valve is expanded to take over the task of properly regulating blood flow.