Is Aortic Stenosis Life-Threatening?

In medical speak, aortic stenosis refers to narrowing (stenosis) of one of the four valves -- the aortic valve -- in your heart. Healthy valves open and close once with each heartbeat and regulate the direction of blood flow through your heart.

A normal aortic valve consists of three triangular flaps of tissue called cusps that move in concert with your heartbeat. The cusps fit together tightly when closed and then open freely so your heart can push oxygenated blood into your aorta. The aorta is the main artery of your circulatory system. Its job is to supply fresh blood to your entire body.

Aortic stenosis can eventually impair the normal function of your aortic valve, which causes your heart to work harder to get enough blood into your aorta. Over time, this extra work can weaken your heart muscle and lead to an enlarged heart, heart failure, and other serious conditions.

The good news is, we have options for successfully treating aortic stenosis and can even provide you with a new valve if necessary.

How it happens

Aortic stenosis is often a result of calcium buildup on the cusps of the aortic valve. The calcium associated with aortic valve stenosis has nothing to do with taking calcium supplements or consuming calcium-fortified foods and drinks.

Rather, it’s a mineral found naturally in your bloodstream that can leave behind calcium deposits as blood moves through your aortic valve. These deposits may accumulate over time and can restrict the blood flow through your aortic valve.

You may never have problems related to these calcium deposits. Sometimes, however, the buildup can stiffen and narrow the aortic valve to the point that it cannot function normally. This type of stenosis is most common in people over 60, but can occur at a younger age, especially if you were born with abnormalities of the valve.

Rheumatic fever, which is a complication associated with strep throat, may cause scar tissue to form on your aortic valve. This tissue can narrow the aortic valve and create a rough surface on the cusps that trap calcium deposits. Rheumatic fever is rare in the United States but can occur when a strep throat infection goes untreated.

Other health factors that appear to increase your chance of developing aortic stenosis include:

•      Conditions linked to cardiovascular health risks, such as diabetes, high cholesterol, and high blood pressure
•      Chronic kidney disease
•      History of radiation therapy to the chest

Diagnosing aortic stenosis

Signs and symptoms of aortic stenosis generally develop when the condition has become more severe and may include:

•      Abnormal heart sound (heart murmur)
•      Chest pain and/or sensation of chest tightness with activity
•      Feeling dizzy or fainting with activity
•      Shortness of breath
•      Fatigue

To confirm a diagnosis of aortic stenosis and better understand the extent of the disease, I may recommend:

•      An echocardiogram, which is a painless study that uses ultrasound technology to evaluate your heart’s function and valve health
•      An electrocardiogram (ECG) that uses wires (electrodes) attached to pads on your skin to measure the electrical activity of your heart and detect enlarged chambers and abnormal heart rhythms
•      A chest X-ray to determine the size of your heart, problems with your aorta, and the condition of your lungs

Depending on your symptoms, I might also prescribe an exercise stress test, or cardiac catheterization/angiography for a closer look at your heart vessels and function and confirm the diagnosis.

Treating aortic stenosis

If your aortic stenosis is mild, I may recommend we monitor it for a while with a close follow-up. It’s always helpful, but especially so with aortic stenosis, to make healthy changes to your lifestyle that may include diet, weight loss, and other actions that decrease your risks of developing diabetes, hypertension, and other conditions that may place a heavier burden on your heart.

Open heart surgery to replace the valve has been the conventional option for treatment of symptomatic aortic stenosis for many years.

I am proud to offer you a less invasive approach called Transcatheter Aortic Valve Replacement (TAVR), which does not involve cracking the chest open. For TAVR, I make a very small incision and insert a hollow tube (catheter) through the arteries in the groin and advance it into your heart. I then use specialized delivery system designed to replace your valve. This minimally invasive procedure, not surgery, allows me to successfully treat your aortic stenosis without needing the opening up of the chest with a large incision required for traditional open heart surgery.

The benefits of TAVR include less risk of bleeding, infection, and other complications associated with traditional surgery. Because it requires less surgical trauma to surrounding tissue structures compared to open surgery, you can usually expect a speedier recovery and quicker healing after TAVR. The risks of stroke and mortality with TAVR are 75% lower than the open heart surgery.

So, call me please if you or your loved ones are suffering from aortic stenosis. I can help!!