Aortic Stenosis is a serious heart condition that is present in the aortic valve. A healthy and functioning aortic valve has three flexible leaflets that open and close, allowing blood to be delivered to the rest of the body. A diseased aortic valve begins to harden and narrow, limiting its ability to adequately open and close.
Aortic stenosis is the blockage of the aortic heart valve and is generally a disease of the elderly. Interventional Cardiologist Dr Gerald Yong provides an explanation of the impact aortic stenosis has on the heart and how it can lead to symptomatic severe aortic stenosis. As he says, “while hearts can cope with it for a while, eventually it will not cope and you will start getting symptoms of the aortic stenosis.”
To picture the effects of aortic stenosis, imagine a tube with thin doors that open and close to allow blood to flow from your heart. When these thin doors calcify, they increasingly become stiffer and it’s more difficult for them to open and close.
A narrower opening of the aortic valve means that it’s more difficult for blood to flow out of the heart and puts increased pressure on the heart. This then requires your heart to work harder to pump blood throughout the body.
There are three main causes of aortic stenosis:
In most elderly adults who develop aortic stenosis, the main cause is from the build-up of calcium on the valves leaflets. This process is described in more detail here. As the disease progresses, the leaflets become stiffer and narrow, limiting their ability to fully open and close.
A normal aortic valve has three leaflets that open and close, allowing blood to flow out of the valve. However, some people are born with one, two or four leaflets in their valve. Additionally, children may be born with leaflets that are partially bonded together or thick leaflets that do not open as they need to1. Much the same as the above cause, aortic stenosis from birth defects will range in severity.
Rheumatic fever is a non-contagious fever that results in inflammation of the joints in response to a bacterial infection, and mostly affects children. Sometimes this illness can cause scar tissue to form in the aortic valve. The presence of scar tissue may create a narrowing in the aortic valve or calcium deposits may attach to the present scar tissue, both typically leading to the development of aortic stenosis. Despite rheumatic fever mostly affecting children, adults can also develop the illness and the off-set effects of rheumatic fever can affect adults who had the condition as a child2.
If you or a loved one has experienced any of these symptoms it’s very important to discuss them with a doctor. Patients who have severe aortic stenosis may have a potentially life-threatening disease, that is a very treatable condition.
Book an appointment with your General Practitioner and discuss your symptoms. Ask your GP To listen to your heart for a murmur.
Diagnosis typically includes a patient history, physical examination and echocardiography (echo), performed by a cardiac sonographer.
Once diagnosis is determined, you may be referred to a Cardiologist or Cardiac Surgeon who will work with you to discuss the severity of the disease and steps going forward.
Fortunately, there are multiple treatment options available for this disease. With the help of your Cardiologist and the heart team, the most suitable treatment option will be determined.
Aortic stenosis is a common heart disease3 with devastating mortality rates. It is estimated that 1 in 8 elderly Australians has aortic stenosis4 and up to 50% of people who develop severe symptoms will die within an average of two years if they do not receive treatment5.
In the above video, Associate Professor Martin Ng discusses the prevalence of aortic stenosis in our community. “With the ageing of our population… we foresee there is going to be a huge increase in the incidence of aortic stenosis in our population, and this is going to be a challenge for our entire healthcare system over time.”