Aortic stenosis is when the valve in the heart gets narrow, which slows down the flow of blood. This can make someone feel tired because their body isn’t getting enough blood. If someone has symptoms because of aortic stenosis, there are treatments that can help stop it from getting worse.
This article talks about what causes aortic stenosis, how doctors diagnose it, and the different ways it can be treated.
What is Aortic stenosis?
Aortic stenosis is a problem with one of the valves in the heart. The heart has valves that work like doors, opening and closing to let blood flow in and out. One of these valves, called the aortic valve, is like a door between the left lower part of the heart (also known as left ventricle) and the main artery called the aorta.
When someone has aortic stenosis, it means that the aortic valve has become narrow. This narrowing makes it harder for blood to flow from the heart to the remaining parts of the body through the aorta.
Symptoms
Symptoms of aortic stenosis can vary, but there are some common signs to look out for. The main ones include chest pain, breathing difficulty, and lose consciousness. Other symptoms that might indicate aortic stenosis include a rapid heartbeat, light-headed or feeling dizzy, swelling in the ankles or feet, sleeping problems, and overall fatigue with decreased activity levels. Interestingly, many people might not notice any symptoms until their blood flow is notably reduced, which can be a serious concern.
Aortic stenosis isn’t just a problem that arises later in life; it can be present from birth. In babies and children, the signs might manifest differently. They may experience fatigue with physical activity, struggle to gain weight as expected, have difficulty feeding, or encounter breathing problems. These early symptoms, though subtle, are crucial indicators that something might be wrong and should prompt medical attention.
Impact
As aortic stenosis advances, it can cause to the left ventricle muscular wall, a chamber of the heart, to thicken. This thickening happens because the heart has to work harder to pump blood across the diminished aortic valve. With a thicker left ventricle wall, there’s less room for blood inside the chamber, which means less blood is being pumped out to the body. Over time, this reduced blood flow can lead to a condition called heart failure, where the heart can’t pump enough blood to meet the body’s needs.
Heart failure is a common complication of aortic stenosis, but it’s not the only one. Other potential problems include pulmonary hypertension, which is high blood pressure in the blood vessels of the lungs, and infective endocarditis, which is a bacterial infection of the heart valve or its lining. Additionally, aortic stenosis can increase the risk of bleeding and blood clots. In severe cases, there’s even a chance of sudden death, highlighting the importance of timely treatment.
Fortunately, treatment options are available to slow down or even reverse the progression of aortic stenosis and reduce the risk of complications. These treatments may help improve symptoms and quality of life while also reducing the chances of serious outcomes.
Causes and risk factors
Aortic stenosis can happen for different reasons. Sometimes, it’s because of a heart problem that’s there since birth, called a congenital heart defect. One example is having a valve in the heart that’s not shaped right, like a bicuspid aortic valve. This can cause extra calcium to build up on the valve, making it narrow.
Sometimes, aortic stenosis develops as a person gets older. For instance, a disease called rheumatic heart disease, which comes from rheumatic fever, can lead to scarring and inflammation in the heart valves, causes aortic stenosis.
Another reason for aortic stenosis can be a health issue like end-stage kidney disease. This condition can make extra calcium build up on the heart valve, making it narrow.
Getting older is also a determinant for aortic stenosis. As people age, calcium can build up on the heart valve and cause scarring. This usually starts happening after someone turns 60, and symptoms might show up when they’re between 70 and 80 aged people.
Diagnosis
Diagnosing aortic stenosis involves a few steps. First, the healthcare provider will talk to the person about any symptoms they’re having and ask about their medical history and any factors that might increase the risk of aortic stenosis.
Next, the healthcare provider will do a physical test. This might include listening to the heart with a stethoscope to check for any unusual sounds, like a heart murmur, and checking the pulse to determine the condition. In newborns, they might also check the abdomen to see if the liver is bigger than it should be.
One important tool doctor use to diagnose heart valve conditions like aortic stenosis is called echocardiography. This test uses sound waves to produce a moving picture of the heart. It helps doctors see how blood is moving through the heart’s chambers and valves and can show the buildup of calcium around the valve.
Sometimes, doctors might also use other tests like CT scans or MRI scans to get more detailed information about how the heart is working. These tests can give doctors a clearer picture of what’s going on inside the heart and help them make the right diagnosis.
Treatment
Treatment for aortic stenosis depends on whether someone has symptoms or not. If they don’t have any symptoms, the doctor might just keep an eye on them to see if any develop over time.
But if the aortic stenosis is severe or if someone has symptoms, the main treatment is usually surgery to replace the aortic valve. This is often the first choice even if the symptoms are mild.
There are different types of valves that can be used for the replacement. One type is a mechanical valve, made of strong materials like metals. Another type is a tissue valve, which can come from either a human donor or an animal.
A newer procedure called transcatheter aortic valve replacement (TAVR) is becoming more common. It’s less invasive than traditional open-heart surgery because it’s done through a tiny incision, usually in the leg, instead of opening up the chest. During TAVR, the new valve is placed on top of the old valve.
TAVR is often a good option for older people, especially if their aortic valve has calcium buildup. Doctors might also recommend it for people who are at high risk for complications from traditional surgery.
Outlook
Individuals with aortic stenosis who don’t have any symptoms, doctors might recommend regular checkups to keep an eye on their condition. How often these checkups happen depends on how severe the aortic stenosis is.
For instance:
- If it’s mild, they might only need checkups every 3 to 5 years.
- If it’s moderate, checkups might be needed every 1 to 2 years.
- And if it’s severe, they might need checkups every 6 to 12 months.
There are some things that can make aortic stenosis worse or progress faster. These include getting older, having a lot of calcium buildup on the heart valve, having hypertension, smoking, having high amounts of fats in the blood, kidney problems, metabolic syndrome, or having high levels of something called lipoprotein(a).
For people who don’t have symptoms, the outlook is usually good. But if they do start having symptoms, getting treatment is really important. Treatment can help improve blood flow and increase the chances of survival.
When to consult a doctor
Sometimes, people with aortic stenosis might not feel any symptoms at all. But if they start feeling tired all the time or notice they can’t do their usual activities like before, it’s a good idea to talk to a doctor. These could be signs that their heart isn’t working as it should, and the doctor can check to see what’s going on.
Summary
Aortic stenosis is a condition where the heart’s valve becomes narrow, affecting blood flow. It can happen for various reasons, including from birth or as a person gets older. Diagnosis involves tests like echocardiography to see how the heart is working.
Treatment options include surgery or less invasive procedures like TAVR. Regular checkups are important for monitoring the condition’s progression. Recognizing symptoms and contacting a doctor promptly can lead to effective treatment and better outcomes.
