Aortic Valve Stenosis

Aortic valve stenosis is a type of heart valve disease, also known as valvular heart disease. The aortic valve is located between the lower left chamber of the heart, called the left ventricle, and the body’s main artery, known as the aorta. In aortic valve stenosis, this valve becomes narrowed and does not open fully. As a result, blood flow from the heart to the aorta and onward to the rest of the body is reduced or blocked.

The severity of aortic valve stenosis can vary. Treatment depends on how advanced the narrowing is and may include careful monitoring or surgery to repair or replace the valve. Without treatment, severe aortic valve stenosis can lead to serious and potentially life-threatening complications.

Symptoms

Aortic valve stenosis can range from mild to severe. Symptoms usually appear when the valve becomes significantly narrowed. Some people may have the condition for many years without noticing any symptoms.

Common symptoms may include:

• Chest pain or a feeling of tightness during physical activity

• Dizziness, lightheadedness, or fainting, especially with exertion

• Shortness of breath, particularly during activity

• Fatigue that worsens with increased activity

• Rapid, fluttering, or irregular heartbeat

In children with aortic valve stenosis, symptoms may include poor appetite and failure to gain weight as expected. As the condition progresses, it may lead to heart failure, which can cause extreme tiredness, shortness of breath, and swelling of the ankles and feet.

Causes

To understand the causes of aortic valve stenosis, it helps to know how the heart valves normally work. The heart has four valves that keep blood moving in the correct direction: the aortic, mitral, tricuspid, and pulmonary valves. Each valve has flaps, also called cusps, that open and close with every heartbeat.

In aortic valve stenosis, the valve between the left ventricle and the aorta becomes narrowed and does not open completely. This narrowing, known as stenosis, forces the heart to work harder to pump blood through the valve. Over time, the extra strain can cause the left ventricle to thicken and eventually weaken.

Common causes of aortic valve stenosis include:

• A congenital heart defect, such as a bicuspid aortic valve, where the valve has two cusps instead of the usual three

• Calcium buildup on the valve, known as aortic valve calcification, which often develops with aging

• Rheumatic fever, a complication of untreated strep throat that can scar and narrow the valve

Risk factors

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

• Older age

• Congenital heart defects, such as a bicuspid aortic valve

• Long-term kidney disease

• Heart disease risk factors, including diabetes, high cholesterol, and high blood pressure

• Infections that affect the heart, such as rheumatic fever or infective endocarditis

• Previous radiation therapy to the chest

Complications

If not properly treated, aortic valve stenosis can lead to serious complications, such as:

• Heart failure

• Stroke

• Blood clots

• Bleeding problems

• Irregular heart rhythms, called arrhythmias

• Heart infections, including endocarditis

Early diagnosis and appropriate management can help reduce the risk of these complications.

Prevention

Not all cases of aortic valve stenosis can be prevented, especially those related to congenital defects or aging. However, certain steps may help lower the risk or slow disease progression:

• Seek medical care for sore throats, as untreated strep throat can lead to rheumatic fever

• Maintain overall heart health by managing blood pressure, cholesterol, weight, and blood sugar levels

• Practice good dental and gum care to reduce the risk of infections that can affect the heart valves

• Attend regular health checkups if you have risk factors or known heart valve abnormalities

Ongoing medical follow-up is essential for detecting changes early and preventing serious outcomes associated with aortic valve stenosis.