Aortic Valve Stenosis

Diagnosis of Aortic Valve Stenosis

Diagnosis of aortic valve stenosis begins with a physical exam and review of your symptoms and medical history. A healthcare professional may listen for a heart murmur using a stethoscope and check blood pressure. Referral to a cardiologist is common for detailed evaluation.

Diagnostic tests may include:

• Echocardiogram: Uses sound waves to create images of the heart and assess blood flow through the aortic valve. A transesophageal echocardiogram provides more detailed internal images.

• Electrocardiogram (ECG or EKG): Measures heart’s electrical activity, detects abnormal rhythms and heart chamber enlargement.

• Chest X-ray: Shows heart size, lung condition, and calcium buildup on the aortic valve.

• Exercise or stress tests: Monitor heart response during physical activity to detect valve-related symptoms.

• Cardiac CT scan: Detailed imaging of the heart and aorta; measures valve calcium and stenosis severity.

• Cardiac MRI: Provides high-resolution images of the heart and aortic valve.

• Cardiac catheterization: Evaluates severity and may be used before valve surgery; involves guiding a catheter to the heart and injecting dye for imaging.

Heart valve disease stages:

• Stage A: At risk. Risk factors present.

• Stage B: Mild/moderate disease, no symptoms.

• Stage C: Severe disease without symptoms.

• Stage D: Severe disease with symptoms.

Treatment of Aortic Valve Stenosis

Treatment depends on symptoms and severity. Goals are to relieve symptoms, prevent complications, and improve quality of life.

Monitoring and Lifestyle:

• Regular checkups and echocardiograms.

• Heart-healthy lifestyle changes: balanced diet, regular exercise, stay active, no smoking.

Medications:

• Treat symptoms and reduce complications.

• Lower blood pressure.

• Prevent irregular heartbeats.

• Remove excess fluid to reduce heart strain.

Surgery and Procedures:

• Balloon valvuloplasty: Opens a narrowed valve, mainly for children or adults too sick for surgery.

• Aortic valve replacement: Damaged valve replaced with mechanical or biological tissue valve (cow, pig, human).

• Transcatheter aortic valve replacement (TAVR): Minimally invasive catheter-based procedure to replace the valve; ideal for intermediate/high-risk patients.

• Ross procedure: Patient’s pulmonary valve replaces the aortic valve; donor valve replaces pulmonary valve.

• Aortic valve repair: Rarely used for stenosis; may involve separating fused valve flaps.

Notes:

• Biological valves can deteriorate over time; mechanical valves require lifelong blood thinners.

• Choice of procedure depends on age, overall health, symptoms, and whether other heart surgeries are needed.