Aortic Stenosis

Aortic stenosis is a heart valve disorder characterized by the narrowing of the aortic valve, which obstructs the flow of blood from the heart’s left ventricle to the aorta. This condition reduces the amount of oxygen-rich blood that reaches the body’s organs and tissues.

 

Types of Aortic Stenosis

There are primarily two types of aortic stenosis:

  • Congenital Aortic Stenosis: This type of aortic stenosis is present at birth and is usually caused by a malformation or abnormality in the structure of the aortic valve.
  • Acquired Aortic Stenosis: This type of aortic stenosis develops later in life due to progressive wear and tear on the aortic valve. The most common cause of acquired aortic stenosis is age-related degeneration.

 

Causes

The causes of aortic stenosis can vary depending on the type:

  • Congenital Aortic Stenosis: The condition may result from genetic factors or abnormalities during fetal development that affect the structure of the aortic valve.
  • Acquired Aortic Stenosis: The most common cause is degeneration of the aortic valve due to age-related wear and tear. Other causes include calcification of the valve leaflets, rheumatic fever, radiation therapy, and certain inflammatory conditions.

 

Symptoms

In the early stages, aortic stenosis may not cause noticeable symptoms. However, as the condition progresses, symptoms can include:

  • Shortness of breath, especially during exertion or when lying flat
  • Chest pain or discomfort (angina), often during physical activity
  • Fatigue or weakness, particularly with exertion
  • Fainting or dizziness, especially with exertion
  • Heart palpitations or irregular heartbeat
  • Swollen ankles and feet (edema)

 

Risk Factors

Several factors increase the risk of developing aortic stenosis, including:

 

  • Age: Aortic stenosis is more common in older adults.
  • Congenital heart defects: Individuals born with certain heart valve abnormalities are at a higher risk.
  • Rheumatic fever: A history of rheumatic fever can increase the risk of aortic stenosis.
  • Bicuspid aortic valve: Having a bicuspid valve (two cusps instead of the normal three) can predispose individuals to aortic stenosis.
  • Calcification: Conditions that promote the buildup of calcium deposits on the valve, such as atherosclerosis or chronic kidney disease, increase the risk.
  • Radiation therapy: Previous radiation treatment to the chest area can lead to aortic valve damage.
  • Family history: Having a family history of aortic stenosis may increase the risk.

 

Diagnosis

To diagnose aortic stenosis, the following tests may be performed:

  • Physical examination: Your doctor will listen to your heart using a stethoscope to detect abnormal heart sounds, such as a heart murmur.
  • Echocardiogram: This ultrasound test allows visualization of the heart’s structure and function, including the aortic valve.
  • Electrocardiogram (ECG): This test records the electrical activity of the heart to check for any abnormal rhythms or patterns.
  • Cardiac catheterization: This invasive procedure involves threading a thin tube (catheter) through a blood vessel to measure pressure and evaluate the severity of the stenosis.

 

Treatment

The treatment for aortic stenosis depends on the severity of the condition and the presence of symptoms. Treatment options may include:

  • Medications: Medications can help manage symptoms and associated conditions, such as high blood pressure or heart failure, but they do not cure aortic stenosis.
  • Valve replacement: For severe aortic stenosis, surgical intervention or a less invasive transcatheter aortic valve replacement (TAVR) may be recommended to replace the damaged valve with a prosthetic valve.
  • Regular monitoring: For asymptomatic or mildly symptomatic cases, regular monitoring of the condition may be appropriate.

 

When to Consult a Physician

It is important to consult a healthcare professional if you experience symptoms such as shortness of breath, chest pain, or fainting. Additionally, individuals with known risk factors for aortic stenosis should undergo regular check-ups and discuss the need for further evaluation. A UTHealth Houston physician can evaluate your symptoms, perform appropriate tests, and provide personalized advice and treatment options.