|
|
Aortic
Stenosis
The aortic heart valve allows for the unidirectional
ejection of oxygenated blood from inside the heart
(left ventricle) to the systemic circulation. Adequate
functioning of the aortic valve is dependent on
its complete opening, which allows the unobstructed
passage of blood, and tight closure (after ejection
of blood) which prevents back flow into the heart.
The progressive narrowing of the aortic valve is
referred to as aortic stenosis (AS).
Causes
|
• |
Rheumatic Heart Disease (secondary to rheumatic
fever) |
|
• |
Congenital Defects (bicuspid valve): found
in up to 2% of the general population
|
|
• |
Idiopathic Sclerosis (scarring of the aortic
valve in the elderly that occurs for unknown
reasons) |
The principal problem with aortic stenosis is obstruction
to blood flow. Those with rheumatic heart disease,
or bicuspid valve, can develop the symptoms of AS
most commonly between the age of 40 and 60. With an
increase of obstruction to blood flow (through the
stenotic valve), the heart attempts to compensate
by enlarging. Eventually, the heart begins to decompensate
and the patient will develop symptoms consistent with
aortic stenosis.
Symptoms
|
• |
Shortness of breath, especially with exercise
|
|
• |
Fainting, especially with exercise
|
|
• |
Chest pain |
|
• |
Heart palpitations |
Advanced AS patients may develop congestive heart
failure and cardiac arrhythmias (atrial fibrillation).
Diagnosis
Evaluation of suspected AS will include: ECG, Chest
X-Ray, and echocardiogram. Some patients may require
cardiac catheterization prior to surgical correction
of the diseased valve.
Treatment
Treatment will consist primarily of artificial heart
valve replacement in those who develop more significant
symptoms. Salt restriction, diuretic therapy (furosemide),
and digoxin are also effective. Strenuous exercise
should be avoided. Those with atrial fibrillation
may require medications to control the rate, and blood
thinning medications (warfarin) to decrease the risk
of stroke.
The Cardiologist is the expert in the evaluation of
this problem.
RETURN
TO ENCYCLOPEDIA 
|
|
|
|
