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Aortic valve stenosis

Aortic valve stenosis
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Heart (Circulatory system)


Aortic valve stenosis
Aortic valve stenosis

Aortic valve stenosis is a condition in which the aortic valve in the heart becomes narrow, restricting the flow of blood from the heart to the rest of the body. The narrowed valve can cause the heart to work harder to pump blood, leading to symptoms such as chest pain, shortness of breath, dizziness or fainting, and fatigue.

Aortic valve stenosis can be caused by a variety of factors, including aging, a previous heart valve infection, congenital heart defects, and calcium buildup on the valve.

Treatment for aortic valve stenosis depends on the severity of the stenosis and the presence of symptoms. In mild cases, lifestyle changes, such as managing blood pressure and avoiding tobacco, may be sufficient to manage symptoms. In more severe cases, surgery to repair or replace the aortic valve may be necessary.

It is important to seek medical attention if you experience symptoms of aortic valve stenosis, as prompt treatment can help prevent serious complications and improve outcomes. Your doctor can perform tests to determine the severity of your condition and recommend the best course of treatment for you. In some cases, regular monitoring of the condition may be recommended to track any changes in the stenosis over time.


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Disease Signs and Symptoms
  • Irregular heart sound (heart murmur)
  • Chest pain
  • Chest tightness
  • Fainting (syncope)
  • Shortness of breath (dyspnea)
  • Fatigue (Tiredness)
  • Irregular heartbeats (arrhythmia)
  • Feeling nauseated, dizzy or fainting around blood or injuries
  • Not gaining enough weight (mainly in children with aortic valve stenosis)

Disease Causes

Aortic valve stenosis

Your heart has four valves that keep blood flowing in the correct direction. These valves include the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Each valve has flaps (cusps or leaflets) that open and close once during each heartbeat. Sometimes, the valves don't open or close properly. If a valve doesn't fully open or close, blood flow is reduced or blocked.

In aortic valve stenosis, the aortic valve between the lower left heart chamber (left ventricle) and the aorta does not open completely. The area through which blood moves out of the heart to the aorta is narrowed (stenosis).

When the aortic valve opening is narrowed, your heart must work harder to pump enough blood into the aorta and to the rest of your body. The extra work of the heart can cause the left ventricle to thicken and enlarge. Eventually the strain can cause a weakened heart muscle and can ultimately lead to heart failure and other serious problems.

Aortic valve stenosis causes include:

  • 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 checkups by a doctor. The valve defect 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. Calcium is a mineral found in your blood. As blood repeatedly flows over the aortic valve, calcium deposits can build up on the heart valves (aortic valve calcification).
  • The calcium deposits may never cause any problems. Aortic valve stenosis that's related to increasing age and calcium deposit buildup usually doesn't cause symptoms until ages 70 or 80. However, in some people — particularly those with a congenital aortic valve defect — calcium deposits result in stiffening of the valve cusps at a younger age.
  • Heart valve calcium deposits aren't linked to taking calcium tablets or drinking calcium-fortified products.
  • Rheumatic fever. This complication of strep throat infection may result in scar tissue forming on the aortic valve. Scar tissue can narrow the aortic valve opening or create a rough surface on which calcium deposits can collect.
  • Rheumatic fever may damage more than one heart valve, and in more than one way. While rheumatic fever is rare in the United States, some older adults had rheumatic fever as children.

Disease Prevents

Aortic valve stenosis

Some possible ways to prevent aortic valve stenosis include:

  • Taking steps to prevent rheumatic fever. You can do this by making sure that you see your doctor when you have a sore throat. Untreated strep throat can develop into rheumatic fever. Fortunately, strep throat can usually be easily treated with antibiotics. Rheumatic fever is more common in children and young adults.
  • Addressing risk factors for coronary artery disease. These include high blood pressure, obesity and high cholesterol levels. These factors may be linked to aortic valve stenosis, so it's a good idea to keep your weight, blood pressure and cholesterol levels under control if you have aortic valve stenosis.
  • Taking care of your teeth and gums. There may be a link between infected gums (gingivitis) and infected heart tissue (endocarditis). Inflammation of heart tissue caused by infection can narrow arteries and aggravate aortic valve stenosis.

Once you know that you have aortic valve stenosis, your doctor may recommend that you limit strenuous activity to avoid overworking your heart.


Disease Treatments
Aortic valve stenosis

Treatment for aortic valve stenosis depends on your signs and symptoms and the severity of the condition.

If you have mild symptoms or none at all, you may only need to have your condition monitored with regular doctor's appointments. Your doctor may recommend healthy lifestyle changes and medications to treat symptoms or reduce the risk of complications.

Surgery or other procedures

You may eventually need surgery to repair or replace the diseased aortic valve, even if you don't have symptoms. Aortic valve surgery may be done at the same time as other heart surgery.

Surgery to repair or replace an aortic valve is usually done through a cut (incision) in the chest. Less invasive approaches may be available. Ask your doctor if you're a candidate for these procedures. Aortic valve surgery may be done at the same time as other heart surgery.

Surgery options for aortic valve stenosis include:

  • Aortic valve repair. To repair an aortic valve, surgeons separate valve flaps (cusps) that have fused. However, surgeons rarely repair an aortic valve to treat aortic valve stenosis. Generally aortic valve stenosis requires aortic valve replacement.
  • Balloon valvuloplasty. This procedure can treat aortic valve stenosis in infants and children. However, the valve tends to narrow again in adults who've had the procedure, so it's usually only done in adults who are too ill for surgery or who are waiting for a valve replacement, as they typically need additional procedures to treat the narrowed valve over time.
  • In this procedure, a doctor inserts a long, thin tube (catheter) with a balloon on the tip into an artery in your arm or groin and guides it to the aortic valve. Once in place, the balloon is inflated, which widens the valve opening. The balloon is then deflated, and the catheter and balloon are removed.
  • Aortic valve replacement. Aortic valve replacement is often needed to treat aortic valve stenosis. In aortic valve replacement, your surgeon removes the damaged valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).
  • Biological tissue valves break down over time and may eventually need to be replaced. People with mechanical valves will need to take blood-thinning medications for life to prevent blood clots. Your doctor will discuss with you the benefits and risks of each type of valve.
  • Transcatheter aortic valve replacement (TAVR). This less invasive procedure may be an option for people who are considered to be at intermediate or high risk of complications from surgical aortic valve replacement.
  • In TAVR, doctors insert a catheter in your leg or chest and guide it to your heart. A replacement valve is then inserted through the catheter and guided to your heart. A balloon may expand the valve, or some valves can self-expand. When the valve is implanted, doctors remove the catheter from your blood vessel. Doctors may also perform a catheter procedure to insert a replacement valve into a biological tissue valve that is no longer working properly.

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