Aortic stenosis (AS) is perhaps the most common and most often cause of sudden death among valvular heart diseases. Its prevalence is low among adults aged < 60 years, but increases to almost 10% in adults ≥ 80 years.
Age related , or degenerative valvular heart disease, represents the most common etiology of aortic stenosis in the elderly population. Degenerative aortic valve disease affects over 25% of all patients over the age of 65.
Severe symptomatic aortic stenosis is associated with a poor prognosis, with most patients dying 2–3 years after diagnosis. We analysed the proportion of patients with severe aortic stenosis not referred for aortic valve replacement (AVR) in a UK-based population and the clinical factors contributing to this.
Symptoms of aortic stenosis may include: Chest pain . Rapid, fluttering heartbeat . Trouble breathing or feeling short of breath. Feeling dizzy or light-headed, even fainting . Difficulty walking short distances. Swollen ankles or feet. Difficulty sleeping or needing to sleep sitting up.
Risk factors of aortic valve stenosis include: Older age. Certain heart conditions present at birth (congenital heart disease) such as a bicuspid aortic valve. History of infections that can affect the heart . Having cardiovascular risk factors, such as diabetes, high cholesterol and high blood pressure.
If left untreated, severe aortic stenosis can lead to heart failure. Intense fatigue , shortness of breath, and swelling of your ankles and feet are all signs of this. It can also lead to heart rhythm problems (arrhythmias) and even sudden cardiac death.
Knowledge of the expected outcomes with mild aortic valve disease is especially important given that aortic sclerosis is present in about 25% of adults over age 65 years and progression to aortic stenosis occurs within 7 years in 16% of patients with aortic sclerosis.
Eat a variety of fruits and vegetables, low-fat or fat-free dairy products, poultry, fish, and whole grains. Avoid saturated and trans fat, and excess salt and sugar.
Thus all afterload reducing agents ( angiotensin-converting enzyme inhibitors , calcium channel blockers , blockers) are contraindicated. However, in patients with mild to moderate aortic stenosis vasodilators such as hydralazine can increase cardiac output.
Patients with aortic stenosis can live full and rewarding lives . However, they may need to be monitored by a heart specialist with office visits and periodic testing. In many cases, aortic stenosis is discovered in patients before they develop any symptoms.
How would I know if I am having symptoms of valve disease? Chest pain or palpitations (rapid rhythms or skips) Shortness of breath , difficulty catching your breath, fatigue , weakness , or inability to maintain regular activity level. Lightheadedness or fainting. Swollen ankles, feet or abdomen.
The severity of aortic stenosis is determined by measuring the aortic valve area (AVA) and calculating the pressure gradient between the left ventricle and the aorta on echocardiography. Aortic stenosis is described as mild, moderate, severe or critical based on these measurements.
The diagnosis of aortic stenosis is made mostly on physical examination and by echocardiography. The ECG in patients with aortic stenosis frequently shows left ventricular hypertrophy with strain and left atrial enlargement; however, these findings are non-specific for aortic stenosis .
Symptoms of severe aortic stenosis include trouble breathing, a rapid heartbeat, and experiencing a variety of symptoms after exertion, such as being very tired, dizziness or fainting, and chest pain . As the aortic valve becomes more stiff and narrow, the heart has a harder time pumping blood to the body.