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About Aortic Stenosis
Aortic stenosis is a condition whereby the aortic valve is narrowed and does not open or close sufficiently and can affect the patient's cardiac output. This may be the result of a Unicuspid (single) or Biscuspid (dual cusp) valve that has not formed completely during gestation. This may lead to increased pressures within the Left Ventricle (LV) due to the increased force required to eject blood from the LV, as well as potentially blood leaking backwards in the LV, causing the LV to dilate and become enlarged. The LV may also thicken (or hypertrophy) as a result of increased force required to eject blood from the LV1.
Signs and symptoms:
Many children with AS may not necessarily have symptoms until the stenosis becomes severe enough, limiting cardiac output.
Children may present with:
- Shortness of breath, especially on exertion
- Syncope of fainting episodes (particularly when exercising)
- Chest pain and tightness
- Sudden cardiac death
Diagnosis:
Aortic Stenosis can be diagnosed through:
- Presence of a heart murmur
- Echocardiogram- demonstrates aortic valve narrowing2.
Treatment:
Patients with paediatric AS rarely require intervention upon diagnosis. AS is a progressive disease that may require correction of the diseased valve once the narrowing is considered critical or the patient is symptomatic.
- Balloon dilatation: otherwise known as Balloon Valvuloplasty is a temporary measure to relieve any symptoms that may occur
- Open heart surgery: may be relevant where balloon valvuloplasty does not assist in the relief of symptoms, this may require surgical adaption of the Bicuspid or Unicuspid valve, or replacement of the aortic valve with a suitable prosthesis3.