Heart Health 101: All About Aortic Stenosis
An adult heart pumps 3-4 litres of blood every minute when you are at rest. This loosely translates to about 2000 gallons of blood circulating through your heart every day. To steadily regulate this massive blood flow, there are numerous components of the human heart that have a crucial role to play. If even one of these elements starts malfunctioning, you might end up being diagnosed with a grave cardiac health condition.
What is Aortic Valve Stenosis?
Aortic Stenosis is one such cardiac complication that has become the most common valvular deformation-related disease in the world. Stenosis refers to the unnatural narrowing of any passage of the body. Aortic valve stenosis occurs when the valve present at the junction between the heart and the aorta (the largest blood vessel of the body) narrows down, reducing the flow of oxygen-rich blood to the body.
What are the implications of Aortic Stenosis?
The aorta is the main artery of the body that carries oxygenated blood to the organs from the heart. Aortic stenosis causes the cusps or leaflets of the valves to thicken or scar which does not allow it to open fully. This causes a blockage in the blood flow, in turn, lessening the amount of oxygen reaching the bodily organs. To make up for this loss, the heart pumps even harder and faster. This results in the weakening of the cardiac muscles, eventually causing the enlargement of the ventricles.
This can ultimately lead to:
- Cardiac arrest, heart failure
- Arrhythmia or abnormal heart rhythm
- Endocarditis or microbial infection of the damaged heart valves
In certain cases, aortic stenosis can be fatal.
Aortic Valve Stenosis symptoms: What are the warning signs?
Your body will indicate several signs to warn you about the onset of Aortic stenosis. Most common aortic stenosis symptoms are:
- Breathlessness
- Angina or chest pain with a feeling of tightness
- Heart palpitations
- Heart murmur or abnormal heart sound
- Frequent fainting
- Weight gain complications
- Severe fatigue
What are the causes of Valve Stenosis?
Aortic valve stenosis can occur as a result of many causes. They include:
- Congenital Heart Defect – Bicuspid Aortic Valve
In a healthy human heart, the aortic valve is tricuspid, meaning, there are three compact, triangle-shaped flaps called cusps in every valve. In certain congenital cardiac malformation cases, some children are born with a bicuspid aortic valve that consists of only two cusps. At adulthood, this causes the aortic valve to narrow or leak, giving rise to aortic stenosis.
- Aortic Valve Calcification
Among all the aortic stenosis causes, aortic valve calcification affects persons aged between 70 to 80 years. With age, heart valves can collect deposits of the calcium mineral as blood repeatedly flows through it. This causes aortic stenosis especially in people born with congenital heart defects like a bicuspid valve. Over time, this calcium accumulation causes the valve cusps to stiffen, hence narrowing the passage.
- Rheumatic fever
A normal strep throat infection, rheumatic fever can prove to be quite significant in terms of aortic stenosis causes. It may result in the formation of scar tissue of the aortic valves which is alone responsible for the occurrence of aortic valve stenosis. In some cases, the scar tissue makes the valve surface rough, allowing more calcium to get accumulated on it.
Aortic Stenosis Treatment: What are my options?
In cases of mild aortic valve stenosis, medications can help control the severity of the condition. This includes diuretics and beta-blockers. When this fails, cardiologists advise the following aortic stenosis treatment:
Conducted through open-heart surgery, this form of aortic stenosis treatment involves the replacement of the dysfunctional aortic valve with metal valves or valve tissues from cows, pigs or human donors.
- Transcatheter Aortic Valve Replacement:
A less invasive aortic stenosis treatment, this procedure requires small cuts and causes less discomfort as compared to the traditional AVR.
- Balloon Valvuloplasty:
For children and infants suffering from aortic valve stenosis, this entails the insertion of a deflated balloon-fixed catheter into the child’s heart which is then inflated to stretch the valve cusps.
Prevention of Valve Stenosis –
Some feasible ways to prevent the onset of aortic stenosis are:
- Prevent rheumatic fever: Do not neglect a sore throat. A strep throat should be immediately treated by doctor-prescribed antibiotics to avert rheumatic fever.
- Lifestyle changes to ensure healthy coronary artery condition: Maintain a balanced diet and stay away from stimulants and drugs. This helps maintain healthy blood pressure and blood cholesterol levels, in turn, reducing the chances of obesity that often leads to aortic valve stenosis.
- Maintain dental hygiene: Gingivitis or infected gums is directly responsible for endocarditis. Proper dental hygiene helps prevent valve stenosis.
Aortic Stenosis FAQ:
- What is an Aortic Stenosis murmur?
The periodic closing of the four valves of your heart causes a sound which is commonly known as the heartbeat. A normal heartbeat has only two distinct sounds. Aortic stenosis murmur refers to the suspicious sounds of whooshing or swishing between the heartbeat lifecycle that can be heard through a stethoscope. Heart murmur often acts as an important sign of aortic stenosis.
- What happens when you have Aortic Stenosis?
Aortic stenosis causes the aortic valve to open only halfway. This reduces the flow of blood into the aorta, depriving the body tissues of oxygen. As a result, the heart starts to pump harder which weakens its muscles, finally leading up to cardiac arrest or heart failure.
- Is Aortic Stenosis life-threatening?
Yes. Aortic valve stenosis significantly weakens your heart which increases the chances of fatality.
- Can Aortic Stenosis be cured?
No medication can cure aortic stenosis, but they can lower the chances of extreme complexities. Affected individuals should also welcome a balanced, stress-free life. For patients with severe conditions, aggressive surgeries are carried out where some procedures repair the valve whereas others replace it. Even then, regular checkups are necessary to ensure the healthy, normal functioning of the heart.
Dr. Mahesh Honnalli, Consultant Cardiology – Adult, SDM Narayana Heart Centre, Dharwad