Description

Stenosis of the aortic valve is a type of heart valve disease, also called heart valve disease. The aortic valve is located between the lower left chamber of the heart and the body's main artery, called the aorta. In the stenosis of the aortic valve, the valve is narrowed and doesn't open fully. This reduces or blocks blood flow from the heart to the aorta and to the rest of the body.

The treatment of aortic stenosis depends on the severity of the condition. The treatment may include surgery to repair or replace the valve. Without treatment, severe aortic valve stenosis can lead to life-threatening complications.

Symptoms

Aortic valve stenosis ranges from mild to severe. The symptoms usually occur when the valve is very small. Some people with aortic valve stenosis may not have symptoms for many years.

The symptoms of aortic valve stenosis may include:

  • Chest pain or tightness with activity.
  • Feeling faint or light-headed or fainting with the activity.
  • Shortness of breath, especially with activity.
  • Fatigue, especially during times of increased activity.
  • Fast, heart palpitations.

Children with aortic valve stenosis may have other symptoms, such as:

  • Not eating enough.
  • Not gaining enough weight.

Aortic valve stenosis can lead to heart failure. Heart failure symptoms include extreme tiredness, shortness of breath, and swelling of the ankles and feet.

When to see a doctor

If you have an irregular heartbeat, or other symptoms of stenosis of the aortic valve, make an appointment with your health care professional.

Causes

To understand the causes of the stenosis of the aortic valve, which may help you to know how the heart and the heart valves tend to work.

The heart has four valves that keep blood flowing in the correct way:

  • The aortic valve.
  • Of the Mitral valve.
  • Tricuspid valve.
  • The pulmonary valve.

Each valve has flaps, also called cusps, which open and close once during each heartbeat. Sometimes, the valves do not open or close properly. If a valve is not fully opened or closed, the blood flow is reduced or blocked.

In the stenosis of the aortic valve, the valve that is located between the lower left heart chamber, called the left ventricle and the body's main artery, called the aorta, is reduced and does not open fully. This narrowing is called stenosis.

When the aortic valve opening is narrowed, the heart must work harder to pump enough blood to the body. The extra work can cause the lower left part of the heart of the camera to get thick. Finally, the heart can become weak.

Aortic valve stenosis causes include:

  • Condition of the heart that are present at birth is called a congenital defect of the heart. Some children are born with an aortic valve that only has two cusps instead of the usual three. If there are only two cusps, it is called a bicuspid aortic valve. Rarely, aortic valve can have one or four cusps.
  • Calcium buildup in the valve, called the calcification of the aortic valve. Calcium is a mineral that is found in the blood. As the blood moves through the aortic valve, the calcium can collect in the valve. The calcium deposits can never cause problems. Stenosis of the aortic valve that is related to the increase of the age and the accumulation of calcium deposits usually do not cause symptoms until the age of 70 or 80. But in some people — especially those with changes in the aortic valve in the birth — deposits of calcium can cause the valve to close at a younger age.
  • Rheumatic fever. This complication of strep throat is not treated, it can damage the valves of the heart. Can cause the formation of scar tissue in the aortic valve. The scar tissue can restrict the opening of the aortic valve. You can also make a rough surface in which the calcium deposits may collect.

Risk factors

Risk factors of aortic valve stenosis include:

  • Advanced age.
  • Some diseases of the heart present at birth, called congenital heart defects. An example is that of a bicuspid aortic valve.
  • Long-term kidney disease.
  • Cardiovascular risk factors, such as diabetes, high cholesterol, and high blood pressure.
  • Infections that can affect the heart, such as rheumatic fever and infective endocarditis.
  • Radiation therapy in the chest.

Complications

The possible complications of aortic valve stenosis are:

  • Heart failure.
  • Stroke.
  • The blood clots.
  • The bleeding.
  • Irregular heartbeats, called arrhythmias.
  • Infections that affect the heart, such as endocarditis.

Prevention

Some of the possible ways to prevent stenosis of the aortic valve are:

  • Get a health checkup when you have a sore throat. Strep throat infection that is not treated can lead to rheumatic fever, which can damage the valves of the heart. Strep throat can usually be treated with antibiotics. Rheumatic fever is most common in children and young adults.
  • Keep your heart healthy. Talk about your risk factors for diseases of the heart with your health care team. Ask how to prevent and manage them. Risk factors such as high blood pressure, obesity and high cholesterol may be linked to the stenosis of the aortic valve.
  • Take care of your teeth and gums. There may be a link between the infected gums, called gingivitis, and a heart infection known as endocarditis. Endocarditis is a risk factor for stenosis of the aortic valve.

Diagnosis

To diagnose aortic valve stenosis, a healthcare professional will examine you and ask questions about your symptoms and medical history. The healthcare provider listens to your heart with a stethoscope. If you have aortic valve stenosis, a sound called a heart murmur can be heard.

Tests

Tests can show if you have aortic valve stenosis. Also you can learn the cause and severity of the condition.

Evidence for aortic valve stenosis may include:

  • The echocardiogram.Use sound waves to create images of the beating heart. An echocardiogram shows how blood flows through the heart and the heart valves. Can you tell how severe stenosis of the aortic valve. The test also can show if the heart muscle is weakened. There are different types of echocardiograms. The type you have depends on the information of your health care team you need. An echocardiogram standard is performed from the outside of the body. An ultrasound device is moved over the skin of the chest over the heart. If you need more over the heart, a transesophageal echocardiogram may be done. This type create images of the heart from the inside of the body. The ultrasound device is attached to a tube that goes down the throat and the esophagus.
  • Electrocardiogram (ECG or EKG). This quick test records the electrical activity of the heart. Shows how the heart beats. Adhesive patches with sensors go in the chest and sometimes the legs. The cables connect the patches to a computer, which displays or prints the results. Your health care professional may look for patterns in the signals related to heart disease or inflammation of the cavities of the heart.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. It can show whether the heart is larger than usual, which may occur at the aortic valve stenosis. They can also inform you if there is a buildup of calcium in the aortic valve.
  • Exercise tests or stress tests. These tests often involve walking on a treadmill or riding a stationary bike while the activity of the heart is activated. Exercise tests show how the heart reacts to physical activity, and if the valve disease symptoms occur during the exercise. If you can't do the exercise, you can receive a drug that affects the heart as the exercise you do.
  • Cardiac computed tomography (CT scan). This test uses multiple X-rays to create detailed pictures of the heart and heart valves. The test may be done to check the size of the aorta and look at the aortic valve more closely. A ct scan may be done to see how much the accumulation of calcium is in the valve. You can also show the severity of the stenosis of the aortic valve.
  • Cardiac magnetic resonance imaging (MRI). A cardiac mri uses magnetic fields and radio waves to create detailed pictures of the heart. This test can show the size of the aorta. Can be used to know the severity of the stenosis of the aortic valve.
  • The cardiac catheterization. This test is not often used to diagnose the disease of the aortic valve. But that can be done to see how severe aortic valve disease is or to diagnose the condition if other tests do not. In this test, the doctor inserts a thin flexible tube into a blood vessel, usually in the area of the groin or arm, and the guide for the heart. Cardiac catheterization can also be used before surgery of the aortic valve, to make sure that the heart arteries are not blocked.

The echocardiogram. Use sound waves to create images of the beating heart. An echocardiogram shows how blood flows through the heart and the heart valves. Can you tell how severe stenosis of the aortic valve. The test also can show if the heart muscle is weakened.

There are different types of echocardiograms. The type you have depends on the information of your health care team you need. An echocardiogram standard is performed from the outside of the body. An ultrasound device is moved over the skin of the chest over the heart. If you need more over the heart, a transesophageal echocardiogram may be done. This type create images of the heart from the inside of the body. The ultrasound device is attached to a tube that goes down the throat and the esophagus.

After the test confirms the diagnosis of aortic valve disease, your health care professional may say that the stage of the disease. Staging helps your healthcare team to choose the most appropriate treatment.

Heart valve disease is staged in four basic groups:

  • Stage A: At risk. Risk factors for heart valve disease are present.
  • Stage B: Progressive. Valve disease is mild or moderate. No valve of the heart of the symptoms.
  • C-stage: Asymptomatic severe. There is no heart valve symptoms, but the disease of the valve is severe.
  • Stage D: Symptomatic severe. Heart valve disease is severe and is causing the symptoms.

The stage of heart valve disease depends on many things, including symptoms, severity of the disease, the structure of the valve or valves and the flow of blood through the heart and lungs.

Treatment

The treatment for aortic valve stenosis depends on the symptoms and the severity of the condition. Aortic valve stenosis ranges from mild to severe.

If you have no symptoms or only mild, you may only need regular medical checkups. Some people need medication to treat the symptoms of valve disease or reduce the risk of complications.

Other treatments for aortic valve disease may include:

  • Heart-healthy lifestyle changes. Eat healthy, exercise regularly and stay active, and do not smoke.
  • Medications to treat the symptoms or reduce the risk of complications.
  • Surgery to repair or replace the valve.

Drugs

Some people with aortic valve stenosis, you may need medication to treat the symptoms or reduce the risk of complications. For example, medications can be used to:

  • Lower blood pressure.
  • Avoid irregular heart beats.
  • Remove excess fluid from the body to reduce the strain on the heart.

Surgery or other procedures

You may need surgery to repair or replace the narrowing of the aortic valve, even if you have no symptoms. Aortic valve surgery can be done at the same time that other types of heart surgery.

Surgery to repair or replace the aortic valve is usually done through a cut in the chest. Less invasive approaches may be available. Ask your health care professional what type of aortic valve is the best treatment for you.

Surgery and procedures for aortic valve stenosis include:

  • The balloon valvuloplasty.This treatment helps to open a narrowing of the valve. Can be done in infants and children with aortic valve stenosis. In adults, the aortic valve tends to narrow again after treatment. For what is normally done only if an adult is too sick for surgery, or if an adult is waiting for a valve replacement. In the balloon valvuloplasty, a doctor puts a thin tube into a blood vessel in the arm or in the groin, and the guide of the aortic valve. Once in place, a balloon at the tip of the catheter is inflated. This makes the valve opening wider. The balloon is deflated. The tube and the ball is removed.
  • Replacement of the aortic valve.Aortic valve replacement is often necessary to treat the stenosis of the aortic valve. In aortic valve replacement, the surgeon carries out the damaged valve and replaces it with a mechanical valve or a valve from a cow, pig or human heart tissue. A tissue valve that is called a biological tissue valve. Sometimes, the aortic valve is replaced with the person's own pulmonary valve called the pulmonary valve. The pulmonary valve is replaced with a biological pulmonary valve tissue from a deceased donor. This more complicated the surgery is called the Ross procedure. Biological tissue valves will break down over time and may eventually need to be replaced. People with mechanical valves need to take anticoagulants for life to prevent blood clots. Talk with your health care team about the benefits and risks of each type of valve.
  • Transcatheter aortic valve replacement (TAVR).TAVR is an option to open-heart valve surgery. Used small cuts and a thin, flexible tube called a catheter to replace the aortic valve. During TAVR, a surgeon replaces a narrowing of the aortic valve with a valve made from cow or pig tissue. TAVR may be an option if you're in an intermediate or higher risk of complications from surgical aortic valve replacement. Ask your health care team about your options. During TAVR, the surgeon places a tube into a blood vessel and guiding it to the heart. A replacement of the valve is made of cow or pig tissue is passed through the tube to the area of the aortic valve. A balloon at the tip tube is inflated to press the new valve in place. Some valves can self-expand. The tube is removed. Surgeons may also use tubes, called catheters, to put a valve replacement in a biological tissue valve that is not functioning properly.
  • Repair of the aortic valve. Surgeons can fix the aortic valve by means of the separation of the valve to lugs that are attached. However, the repair of the valve is rarely used to treat aortic valve stenosis. Generally stenosis of the aortic valve requires replacement of the aortic valve.

The balloon valvuloplasty. This treatment helps to open a narrowing of the valve. Can be done in infants and children with aortic valve stenosis. In adults, the aortic valve tends to narrow again after treatment. For what is normally done only if an adult is too sick for surgery, or if an adult is waiting for a valve replacement.

In the balloon valvuloplasty, a doctor puts a thin tube into a blood vessel in the arm or in the groin, and the guide of the aortic valve. Once in place, a balloon at the tip of the catheter is inflated. This makes the valve opening wider. The balloon is deflated. The tube and the ball is removed.

Replacement of the aortic valve. Aortic valve replacement is often necessary to treat the stenosis of the aortic valve. In aortic valve replacement, the surgeon carries out the damaged valve and replaces it with a mechanical valve or a valve from a cow, pig or human heart tissue. A tissue valve that is called a biological tissue valve.

Sometimes, the aortic valve is replaced with the person's own pulmonary valve called the pulmonary valve. The pulmonary valve is replaced with a biological pulmonary valve tissue from a deceased donor. This more complicated the surgery is called the Ross procedure.

Biological tissue valves will break down over time and may eventually need to be replaced. People with mechanical valves need to take anticoagulants for life to prevent blood clots. Talk with your health care team about the benefits and risks of each type of valve.

Transcatheter aortic valve replacement (TAVR). TAVR is an option to open-heart valve surgery. Used small cuts and a thin, flexible tube called a catheter to replace the aortic valve. During TAVR, a surgeon replaces a narrowing of the aortic valve with a valve made from cow or pig tissue. TAVR may be an option if you're in an intermediate or higher risk of complications from surgical aortic valve replacement. Ask your health care team about your options.

During TAVR, the surgeon places a tube into a blood vessel and guiding it to the heart. A replacement of the valve is made of cow or pig tissue is passed through the tube to the area of the aortic valve. A balloon at the tip tube is inflated to press the new valve in place. Some valves can self-expand. The tube is removed. Surgeons may also use tubes, called catheters, to put a valve replacement in a biological tissue valve that is not functioning properly.

Lifestyle and home remedies

Try these tips to help prevent or delay the stenosis of the aortic valve and other types of heart disease.

  • Do not smoke or use tobacco. Smoking is a major risk factor for heart disease. If you smoke and can't stop smoking, talk with your health care team about the programs or treatments that can help.
  • Eating a heart-healthy diet. Eat a variety of fruits and vegetables, low-fat or non-fat dairy products, poultry, fish and whole grains. Limit the salt and saturated fat.
  • Maintain a healthy weight. Lose weight if you are overweight or have obesity. Losing just a few pounds can help reduce risk factors for diseases of the heart. Ask your healthcare professional what is the ideal weight for you.
  • Get regular exercise. Exercise helps control your weight and control risk factors for heart disease. Exercise at least 30 minutes a day on most days of the week. Talk with your health care team about the amount and type of exercise is best for you.
  • Manage stress. Learn ways to help reduce emotional stress. Some ideas for to do more exercise, the practice of mindfulness or connect with others in support groups.
  • Control of blood pressure, blood sugar and cholesterol. Make lifestyle changes and take medications as directed. Get health checkups.
  • Limit the consumption of alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
  • Sleep well. Lack of sleep can increase the risk of heart disease and other health conditions. Adults should get 7 to 9 hours a day.

If you have aortic valve stenosis, your health care team may recommend that you limit strenuous activity to avoid excess work of your heart.

Pregnancy and aortic valve disease

If you have aortic stenosis and are considering the possibility of pregnancy, it is important to talk with your health care team about your plans. Together, you can talk about the safety of medicines and if you need treatment for aortic valve stenosis before you get pregnant.

Those with heart valve disease, such as aortic valve stenosis, generally require close of check-ups by a health professional during pregnancy. If you have severe aortic stenosis, the health care professional can tell you not to get pregnant due to the risk of complications.

Preparing for your appointment

If you think you have the disease of the aortic valve, make an appointment for a health checkup. Consider the possibility of being seen and treated in a medical center with a multidisciplinary heart valve team. This is a team of heart doctors, called cardiologists and other health professionals trained and experienced in the heart valve disease.

Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of pre-appointment restrictions. When you make the appointment, ask if there is something that you need to do beforehand. For example, you may be asked not to eat or drink anything for a couple of hours before a cholesterol test.
  • Write down your symptoms, including any that seem unrelated to the stenosis of the aortic valve or the heart.
  • Write important personal information. Include a family history of heart disease, and any major stresses or recent life changes.
  • Make a list of all the medicines, vitamins, and supplements you are taking. Include the dose.
  • Take someone with you, if possible. Someone who goes with you can help you remember the information that you receive.
  • Write questions to ask their health professional.

For aortic valve stenosis, some basic questions to ask your health care professional are:

  • What is the likely cause of my symptoms or condition?
  • What are other possible causes?
  • What tests do I need?
  • What is the best treatment?
  • What are the options for the treatment you suggest?
  • I have other health conditions. How can I best manage them together?
  • How do I change my diet or activities?
  • You should see a specialist?
  • If I need surgery, a surgeon who would I recommend to the heart valve surgery?
  • There is some information about my condition, that I can take home with me? What sites do you recommend?

Do not hesitate to ask any other questions.

What to expect from your doctor

Your health care team is likely to ask many questions, such as:

  • When did the symptoms begin?
  • Do you always have symptoms, or come and go?
  • How bad are the symptoms?
  • What, in any case, it makes your symptoms better?
  • What, in any case, it makes your symptoms worse?
  • Does anyone in your family have heart disease?
Symptoms and treatment of Aortic valve stenosis