Aortic Stenosis
Aortic stenosis is a condition where the aortic valve in the heart becomes narrowed, which restricts blood flow from the heart to the rest of the body. This can lead to symptoms like chest pain, shortness of breath, and fatigue, and may require treatment such as valve replacement if severe.
Don’t assume it’s your age, it could be your heart!
Symptoms of severe aortic stenosis include:
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Chest pain or tightness (angina)
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Feeling faint upon exertion
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Fatigue
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Shortness of breath upon exertion
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Reduced exercise capacity
Remember however, that aortic stenosis often occurs with no outward symptoms and may go undetected. If you are over
the age of 75, it is important you ask your doctor to listen to your heart.
What is aortic stenosis?
Did you know 1 in 8 people over the age of 75 have aortic stenosis?
The aortic valve is positioned at the top of the left ventricle and leads to the aorta, the major large vessel that circulates oxygenated blood to your body. The valve has leaflets which control when the blood flows into the aorta. Aortic stenosis is a heart valve disease that occurs when calcium deposits on the valve cause the leaflets to become stiff. As the condition progresses, the valve opening narrows, making it harder for your heart to pump blood through the valve and around the body. As your heart is having to work a lot harder, you may notice the common
symptoms of aortic stenosis.
What causes aortic stenosis?
Calcium build-up on the valve:
With age, heart valves may accumulate calcium deposits.
Birth defect:
Some people are born with an aortic valve that has only one or two leaflets instead of three. This may
not cause any problems until adulthood, at which time the valve may begin to narrow or leak.
Rheumatic fever:
This may result in scar tissue on the aortic valve, which can narrow it or can create a rough surface
where calcium deposits can collect.
Radiation therapy:
In rare cases, calcification of the aortic valve can occur more quickly in patients who have received
radiation treatment to the chest.
What are the treatment options for aortic stenosis?
The only effective treatment method for severe aortic stenosis is to replace your aortic valve. Today there are two options to replace your diseased aortic valve. Only professionals who have received extensive training are qualified to perform a valve replacement procedure, such as a multidisciplinary heart team. A properly trained and dedicated team will conduct a thorough evaluation to determine the most
appropriate treatment option for you.
Transcatheter Aortic Valve Implantation (TAVI)
TAVI is a treatment option for severe aortic stenosis, that is designed to
replace a diseased aortic valve through a catheter. TAVI is a minimally-invasive procedure that uses a catheter to implant a new valve within your diseased aortic valve. TAVI can be performed through multiple
approaches; however, the most common approach is the transfemoral approach (through a small incision in the leg). Please consult a heart team for more information on TAVI and its associated risks.
Open heart surgical aortic valve replacement
Aortic valve replacement through open heart surgery is another option for treating severe aortic stenosis. Most open heart surgeries are performed through an incision across the full length of the breast bone, or sternum. Occasionally open heart surgeries can be performed through smaller incisions. Open heart surgeries, including those performed through smaller incisions, require the use of a heart lung machine which temporarily takes over the function of the heart. During the procedure, the surgeon will completely remove the diseased aortic valve and insert a new valve. There are two different types of surgical valves: mechanical (man-made material) and biological (animal or human tissue). Please consult our heart team for more information on surgical aortic valve replacement and its associated risks.
Questions to ask your doctor:
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What could be causing my symptoms?
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What tests do I need to be diagnosed?
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Should I see a cardiologist or Heart Team that is specially trained in the diagnosis and treatment of aortic stenosis?
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How frequently will I need to have follow-up visits to monitor my aortic stenosis?
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How long before my aortic stenosis may become so severe that I need to have my valve replaced?
Understand your risk factors
Factors associated with aortic stenosis include:
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Increasing in age
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High blood pressure
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High cholesterol
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Smoking
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Deformed aortic valve
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Family history
Severe aortic stenosis has a worse prognosis than many metastatic cancers.
The 5-year survival rate of untreated symptomatic SAS is worse than for
several metastatic cancers, including colorectal, breast, ovarian and prostate cancer.
Diagnosis of Angina
Echocardiogram:
This is also known as an ultrasound; it uses sound waves to produce an image of your heart, which helps your doctor closely examine the
aortic valve.
Auscultation:
Your cardiologist will use a stethoscope to listen to the sounds of your heart.
Electrocardiogram (ECG):
Sensors are attached to your skin to measure the electrical impulses given off by your heart, displayed as waves on a monitor or printed on paper.
Chest X-ray:
An X-ray image of your chest allows your doctor to check the size and shape of your heart. A chest X-ray can also reveal calcium deposits on the aortic valve.
Cardiac catheterisation:
In this test, a dye is injected into your heart through your arm or groin to make your heart more visible on an X-ray.
What should you do if you think you have aortic stenosis?
You’ll probably start by first seeing your family doctor who may then refer you to a multidisciplinary heart team at a specialised heart centre near you who can evaluate you for all your treatment options.
Before your appointment, knowing as much as possible about your family’s health history will help your doctor make informed decisions.