Aortic Valve Stenosis
Stenosis can mean that the leaflets or cusps of your valve have thickened or scarred and don’t open as well as they should. So with each beat, less blood leaves the heart to go out and nourish your body.
Causes
Calcium buildup
Your blood carries calcium, among other minerals and nutrients. As blood passes through the aortic valve year after year, calcium deposits can form on the valve. This can make it stiffer, so it won’t fully open.
Heart defect from birth
A normal aortic valve has three flaps, or cusps, that fit snugly together. Some people are born with an aortic valve that has one, two, or even four cusps. The heart can function just fine this way for years.
But as you move into adulthood, the abnormal valve is more likely to get stiffer and not open as well. This type of congenital heart defect can be treated by repairing or replacing the valve.
Rheumatic fever
Though this complication from strep throat or scarlet fever isn’t nearly as common as it once was, it can still pose a threat. Rheumatic fever can scar the aortic valve. Scar tissue makes it easier for calcium to build up on the valve.
Symptoms
When you have mild aortic valve stenosis, you may never feel any symptoms. It can often take a long time for symptoms to become more noticeable. Gradual signs of a weakening heart can sometimes be overlooked.
For serious cases, there are some symptoms worth noting. They include:
Shortness of breath, especially during exercise
Chest pain or tightness
Feeling faint or lightheaded
Fatigue
Heart palpitations (rapid or fluttering heartbeat)
Heart murmur (an extra beat in between your usual heartbeats)
Diagnosis
Echocardiogram
This imaging test uses sound waves to create a picture of your heart’s structure. An echocardiogram can often tell whether your valve has thinned.
Electrocardiogram
This measures electrical activity in the heart. It can help your doctor find out where there has been any heart failure, possibly caused by aortic valve stenosis.
Exercise stress test
During the test, you will walk briskly on a treadmill or ride a stationary bicycle to increase your heart rate. If you don’t have symptoms, seeing how your heart responds to exercise can help your doctor diagnose aortic valve stenosis, as well as other heart problems.
Cardiac catheterization
If there is not yet enough evidence, your doctor may ask you to have this procedure. During it, your doctor threads a thin, flexible tube into your arm. A special dye and an X-ray movie show a more detailed look at your heart’s valves and chambers.
Treatment
Aortic valve replacement
It’s done with mechanical valves made of metal or with valve tissue from cows, pigs, or human donors.
Your surgeon may replace the valve using traditional open-heart surgery, during which they make a cut down your chest wall and open your rib cage.
Or they may go with a catheter procedure called transcatheter aortic valve replacement (TAVR).
TAVR is a less invasive procedure, meaning your surgeon uses much smaller cuts than with open-heart surgery.
People usually have an easier time recovering and have less discomfort with this procedure.
Which one you and your surgeon decide to go with depends on the details of your specific case.
Balloon valvuloplasty
This procedure is usually for infants and kids with aortic valve stenosis. It’s less effective for adults.
In the procedure, a doctor guides a catheter (a long, flexible tube) through a blood vessel and into the heart.
At the tip of the catheter is a deflated balloon.
When the tip reaches the valve, the balloon is inflated, pushing open the stiff valve and stretching the cusps.