Aortic Stenosis – Getting to the heart of the matter

Aortic Stenosis is a narrowing of the aortic heart valve opening. The aorta is the main artery in the body and vital in delivering oxygen rich blood to the entire system. The narrowing is usually caused by age related calcification but can also be attributed to birth defects, radiation therapy or a bout with rheumatic fever (scar tissue in the case of rheumatic fever rather than calcification can cause the stiffening). With Aortic Stenosis your heart is forced to work harder and may not be able to pump enough oxygen enriched blood throughout your body.

When calcium builds up on the heart valves or scarring and thickening occurs it reduces their ability to open and close readily. The result is that less oxygenated blood is able to travel to the brain and other organs. It is important to note that this condition does not always present symptoms outwardly.

How to recognize the signs:

You may experience

  • Fatigue
  • Chest pain
  • Shortness of breath
  • Dizziness
  • Fainting
  • Having a more difficult time than usual exercising
  • Heart palpitations
  • Cough without being sick
  • Decreased urination

You are at a higher risk if you smoke, have high blood pressure, have consistently high cholesterol levels, and are 65 or over or have a family history of heart disease. Men are more likely to develop aortic stenosis than women.

If aortic stenosis is left untreated, complications generally will occur over time.

• Left ventricular hypertrophy (enlargement of the heart muscle) caused because the heart pumps blood through a narrow valve

• angina pectoris (chest pain) which generally worsens with physical exercise

• heart failure

• sudden death due to arrhythmias (irregular heart beat)

• endocarditis (infection of the innermost layer of the heart valve)

Valve replacement is the recommended option.

This can be achieved by minimally invasive techniques or as an open heart surgery. The minimally invasive technique (Trans-femoral aortic valve replacement TAVR) is performed through a needle stick in the femoral artery which is in the upper thigh area. The valve is delivered via small plastic tubes called catheters and deployed in position. All this while under anesthesia and being continuously monitored. Surgically, the surgeon must make an incision in the center of the chest through the breastbone. The chest is then opened to expose the heart. The surgeon then opens the pericardium (lining that protects the heart). The damaged valve is then removed. As the final step the prosthetic replacement valve is inserted and sewn into the heart. This valve is made from either human or pig skin donor skin.

The American Board of Internal Medicine and Cardiovascular Disease conducted a study of 7584 patients who underwent aortic valve replacement surgery, including 815 over the age of 80. They found that short and long-term survival was favorable across all age groups. Specifically, more than half of the patients undergoing aortic valve procedures were alive 6 years after surgery. Without valve replacement, those diagnosed with this condition have a 50% chance of living only another 2 years.

It is important in order to achieve the best possible outcome, if you are having any of these symptoms to be evaluated by a doctor as soon as possible.

Tampa Cardiovascular Associates invite you to call us at 813-975-2800 or contact us through the web.

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