Aortic Valve Stenosis – The Often-Overlooked Cardiac Condition

There are many heart disorders that we are all aware of, such as coronary artery disease, cardiomyopathy, and so on. However, there is one condition, aortic valve stenosis, which is much less well-known, but which can have life-threatening consequences if not diagnosed and treated in a timely manner.

The aortic valve controls the flow of blood from the heart to the main artery, the aorta, which carries the blood through the body. When stenosis is present, the valve is narrowed or calcified and hence unable to function properly. Therefore, the flow of blood is affected. Aortic stenosis is common among people over the age of 65. In many cases, patients remain asymptomatic (with no symptoms), and unless there is a sudden change in their cardiac health status, never get to know that they have a potential problem. In other cases, the condition is diagnosed when symptoms appear or routine health checkups reveal the presence of the condition.

Aortic valve stenosis can progress at varying rates, and if left undiagnosed and untreated till it reaches an advanced stage, it can be life-threatening.

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Symptoms

The symptoms of this condition include:

• Sudden bouts of fatigue
• Shortness of breath
• Swelling of the lower legs, ankles and feet
• Heart palpitations – when the heartbeat is so pronounced that you are aware of it
• Chest pain (angina) – a feeling of squeezing or excessive pressure in the chest, which may extend to the abdomen, arm, neck or jaw
• Dizziness, fainting or lightheadedness

These symptoms may also indicate the existence of other medical disorders, which is why consulting a cardiologist to confirm the diagnosis and decide on the correct course of treatment is important.

Diagnosis

Diagnosing the existence of aortic valve stenosis typically involves the following:

• Physical examinations to look for visible symptoms
• Electrocardiogram (ECG or EKG) to measure the heart’s electrical activity
• An echocardiogram which uses sound waves to create an image of the inside of the heart.
• Heart MRI (magnetic resonance imaging) for a detailed look at the heart

Treatment

The treatment will depend on the patient’s overall health and how advanced the condition is.

• If diagnosed in the very early stage with the patient asymptomatic, cardiologists may recommend monitoring the condition to see how it progresses before taking any action.
• If the condition is a mild one, medication may be enough to treat it, at least in the initial stages. This may consist of blood thinners, diuretics and medications to control heart rhythm and blood pressure. Balloon valvuloplasty may be used to widen the narrowed valve to improve blood flow so as to postpone surgery. This is often the course of action if other health concerns complicate a surgical solution.
• If the aortic valve is damaged but can be repaired, a surgeon may choose to go in for valve repair surgery. For this, an incision is made in the chest to enable the surgeon to directly access the heart and do the required repairs to the valve.
• If valve repair is not viable, then valve replacement is the course of action. There are multiple replacement options, including tissue valves (typically from cows or pigs) or mechanical valves. Both types of valves have their positives and a surgeon will recommend which one to go for based on an evaluation of the patient’s health, age and other factors. If viable, a transcatheter aortic valve replacement (TAVR), which involves delivering a new valve using a catheter-based device through an artery and threading it to the heart, is another option.

Recovery

Recovery from aortic valve stenosis surgery usually involves several days of hospital stay after the procedure. Once the surgeons are satisfied with the progress, the patient will be allowed to return home to continue the rest and recuperation. Before leaving the hospital, the patient will be given a detailed medication plan, diet chart and physiotherapy plan. The progress of the recovery will be monitored during follow-up visits to the cardiologist. In general, patients can begin to undertake light activities after a few weeks. The amount of activity may be gradually increased over the course of a few weeks or months until a complete return to normal work and other normal activities is achieved.

Aortic valve stenosis is a serious cardiac condition and cannot be taken lightly. That said, advances in cardiac valve repair and replacement procedures mean that treatment that will allow a patient to live a long and normal life is very possible. However, a reason for late presentation by patients is that the condition often develops long before the patient notices symptoms and as a result, it reaches an advanced stage by the time treatment begins. That is why regular health check-ups, which will enable early detection of this and other health issues, are so important. Once a diagnosis of aortic valve stenosis is confirmed, treatment must begin without delay. Receiving treatment at a multispecialty hospital like New Medical Centre in Pondicherry is the best option. Not only is there a world-class cardiology department with the best doctors and surgeons, but the most advanced diagnosis, treatment and surgical options are also available. This means that patients can rest assured that they will receive the best in treatment which will allow them to return to an active and healthy life.

It is common for patients, especially those who are middle-aged or elderly, to have other health concerns along with aortic valve stenosis. Being treated at a multispecialty hospital means that a range of medical specializations are available at one place, so that patients may receive complete and holistic care and treatment without having to travel to different places.

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Frequently Asked Questions About Aortic Valve Stenosis

1. What is aortic valve stenosis?
   Aortic valve stenosis is a heart condition in which the aortic valve becomes narrowed or stiff due to calcification or damage, restricting blood flow from the heart to the rest of the body.
2. Who is most at risk of developing aortic valve stenosis?
   Aortic valve stenosis is most common in people over the age of 65. However, it can also occur in younger individuals due to congenital valve defects, infections, or other heart conditions.
3. Why is aortic valve stenosis often overlooked?
   Many patients remain asymptomatic for years. Because symptoms may not appear until the condition becomes advanced, it often goes undiagnosed unless detected during routine health checkups.
4. What are the common symptoms of aortic valve stenosis?
   Symptoms may include fatigue, shortness of breath, swelling in the legs or ankles, chest pain, heart palpitations, dizziness, or fainting. These symptoms often worsen as the condition progresses.
5. Can aortic valve stenosis be life-threatening?
   Yes. If left untreated, severe aortic valve stenosis can lead to heart failure, fainting episodes, or sudden cardiac death. Early diagnosis and timely treatment are critical.
6. How is aortic valve stenosis diagnosed?
   Diagnosis typically involves physical examination, electrocardiogram (ECG), echocardiogram, and advanced imaging tests such as cardiac MRI to assess valve function and heart structure.