Aortic valve stenosis is a type of heart valve disease where the valve between the lower left heart chamber (left ventricle) and the aorta becomes narrowed. This narrowing reduces or blocks blood flow from the heart to the rest of the body, forcing the heart to work harder to pump blood. Without proper treatment, severe aortic valve stenosis can lead to life-threatening complications.
Symptoms
Symptoms of aortic valve stenosis often appear when the valve becomes severely narrowed. These may include:
- Chest pain or tightness, especially during activity.
- Dizziness or fainting, often triggered by physical activity.
- Shortness of breath, particularly with exertion.
- Fatigue, even during light activity.
- Rapid or fluttering heartbeat (palpitations).
In Children
- Poor appetite or not eating enough.
- Difficulty gaining weight.
If the condition progresses, it may lead to heart failure. Symptoms of heart failure include:
- Severe tiredness or fatigue.
- Shortness of breath.
- Swollen ankles and feet.
When to See a Doctor
Seek medical attention if you experience:
- Chest pain, shortness of breath, or fainting with activity.
- Fatigue and swelling in the lower limbs.
- An irregular or rapid heartbeat.
Early detection and management are critical to prevent complications.
Causes
Aortic valve stenosis can be caused by:
- Congenital Heart Defects
- Some people are born with an abnormal aortic valve, such as a bicuspid valve (two cusps instead of three).
- Calcium Buildup
- Over time, calcium deposits may accumulate on the aortic valve, leading to stiffening and narrowing (common with aging).
- Rheumatic Fever
- A complication of untreated strep throat, rheumatic fever can cause scar tissue to form on the valve, leading to narrowing.
Risk Factors
Factors that increase the risk of aortic valve stenosis include:
- Age: Risk increases with age due to calcium buildup.
- Congenital Heart Defects: A bicuspid or other abnormal valve structure.
- Chronic Conditions: Long-term kidney disease, diabetes, and high cholesterol.
- Infections: Rheumatic fever or infective endocarditis.
- Radiation Therapy: Past radiation treatments to the chest.
Complications
Without treatment, aortic valve stenosis can lead to severe complications, such as:
- Heart failure: The heart struggles to pump blood effectively.
- Stroke: Due to blood clots or irregular blood flow.
- Arrhythmias: Irregular heart rhythms.
- Infections: Increased risk of infective endocarditis.
- Sudden Cardiac Arrest: In severe cases.
Diagnosis
Tests to diagnose aortic valve stenosis include:
- Echocardiogram:
- The primary test to assess valve structure and blood flow.
- Electrocardiogram (ECG):
- Measures electrical activity of the heart.
- Chest X-ray:
- Shows heart size and calcium deposits on the valve.
- Stress Tests:
- Evaluate how the heart responds to exertion.
- Cardiac Catheterization:
- Provides detailed images of the heart and its valves.
Treatment
Treatment depends on the severity of the condition:
Lifestyle Changes and Monitoring
- Mild Cases: Regular monitoring and managing risk factors like high blood pressure and high cholesterol.
Medications
- To manage symptoms or treat related conditions, such as heart failure or arrhythmias.
- Medications do not reverse valve narrowing.
Surgery or Procedures
- Valve Repair:
- Less common but possible in certain cases.
- Valve Replacement:
- Mechanical Valves: Durable but require lifelong blood-thinner medication.
- Biological Valves: Made from animal or human tissue; may need replacement over time.
- Transcatheter Aortic Valve Replacement (TAVR):
- A less invasive option for those who can’t undergo open-heart surgery.
Prevention
While not all cases can be prevented, certain measures can reduce the risk:
- Treat Strep Throat Promptly:
- Prevent rheumatic fever by treating strep throat with antibiotics.
- Maintain Heart Health:
- Control blood pressure, cholesterol, and diabetes.
- Oral Health Care:
- Prevent gum infections that could lead to endocarditis.
- Regular Checkups:
- Early detection of valve abnormalities through routine health screenings.
Prognosis
With proper treatment, many people with aortic valve stenosis can lead full and active lives. Regular follow-ups are essential to monitor heart function and ensure timely intervention if the condition worsens.