About the disease
Aortic valve stenosis is the narrowing of the aortic valve, when free flow of blood from the left ventricle is obstructed. In aortic valve stenosis the valve can not open completely, so the blood flow gets stuck. Because of this narrowing the heart muscle needs to work twice as hard, that`s why person with aortic valve stenosis feels dizziness, weakness, problems with breathing and he can faint. Aortic valve stenosis is much more frequently diagnosed among men than among women. Isolated and exceptional case of aortic valve stenosis is very rare, usually it is combined with other heart valve defects, such as mitral stenosis or aortic insufficiency. If a person has bicuspid aortic valve, he can also develop aortic valve stenosis, because his valve forms bicuspid configuration instead of tricuspid, which is normal.
Causes:
- Atherosclerosis
- Infectious endocarditis
- Disease of Paget
- Rheumatoid arthritis
- Renal disease
Symptoms
- Shortness of breath, when it becomes very difficult for the patient to breath
- Fatigue, when patient feels tired even in the morning
- Weakness of almost all muscles
- Strange palpitations
- Heaviness in the chest close to the heart
Unexpected cardiac death in valve stenosis occurs in 4-7% of cases, mostly among elderly patients with progressed narrowing of the valve opening.
Diagnosis
Almost all patient with stenosis of aortic valve have a very pale skin. During the medical appointment a doctor inspects the medical history to see if there were some diseases in the patient's past which could cause stenosis of valve. He also asks a patient if there were some members in his family which suffered from the valve insufficiency. Sometimes a doctor may ask a patient to do several simple physical exercises to see if there is enough oxygen in patient`s lungs to undergo normal physical activity without shortness of breath, dizziness and palpitations. Usually patients with stenosis of aortic valve do not have enough oxygen in their system, as aorta is mainly responsible for distributing oxygen throughout the patient's body. Also during the general examination a doctor may notice that the palpation of apical impulse is displaced. ECG can show the signs of valve hypertrophy, arrhythmias and sometimes - the aortic block.
Most effective method of aortic valve stenosis diagnosis is echocardiography, which shows if there are disruptions in the blood pumping of the valves.
Treatment
All patients, including those who have asymptomatic stenosis of valve, should be under the close supervision of a cardiologist. They are recommended to conduct echocardiography every 5-11 months. Those who have stenosis of valve need to take serious antibiotics before dental or any surgical procedures. Pregnancy for woman with aortic valve stenosis requires careful monitoring of woman`s heart rate. Abortion is indicated in severe degree of aortic valve stenosis since it may result in heat failure.
- Valve stenosis surgery is required if there is severe shortness of breath and constant dizziness. If it is difficult for the patient to breath, doctors may use the balloon valvuloplasty, which can dilate the aortic stenosis and let more oxygen in. Main purpose of any aortic valve stenosis surgery is the widening of the valve. It can be achieved not only during the balloon valvuloplasty.
- Aortic valve replacement is a procedure, when the affected valve is completely removed and replaced by its mechanical analogue or valve tissue of the donor or animal. Patients with artificial implanted valves require lifelong monitoring. If there was a mechanical replacement of aortic valve, a patient may accumulate certain blood clots throughout his lifetime, that's why he must take drugs which will prevent blood clots. Valve tissues may need to be replaced or transmitted in future.
- Transcatheter aortic valve replacement (TAVR) also aims to replace the valve, but this procedure is less invasive and is performed with catheter.
Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko
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