Aortic Stenosis, Media

The National Pursuit to Reduce Valvular Heart Disease Deaths

Leading cardiologists are continuing to support our national campaign to educate the medical community and patients who may be living with undiagnosed aortic stenosis.

Aortic stenosis is an age-related disease most prevalent in people in their 70s and over.

It is estimated that 1 in 8 elderly Australians has aortic stenosis1. Up to 50% of people who develop severe Aortic Stenosis symptoms will die within an average of two years if they do not have their aortic valve replaced2.

“One of the problems about why this deadly, but very treatable condition, is being underdiagnosed and undertreated is the assumption that the shortness of breath is just part of ageing. It may not be. It may well be because our patients may have a serious cardiac problem such as aortic stenosis, a treatable condition,” Professor Martin Ng explains.

Professor Martin Ng, Interventional Cardiologist at Macquarie University, has teamed up with leading Cardiologists across Australia to help raise awareness for this valvular heart disease through a national aortic stenosis educational campaign, Hope For Hearts.

“The most important part of our mission with Hope For Hearts is to increase awareness of aortic stenosis. Awareness is the first and vital step in treating this deadly condition,” said Professor Martin Ng.

“It’s important to understand that aortic stenosis has been known for decades to be deadly, but actually most of the data in our medical textbooks is derived from studies that stem from the 1960s or ’70s. These were studies in people who were much, much younger.

Fortunately, our life expectancy has improved and the number of people in our population who are over 80 has significantly increased in this time. It appears we still live in a world where a lot of our understanding about aortic stenosis is centred around this information that we accumulated decades ago from a much younger patient cohort.”

The majority of patients with aortic stenosis are asymptomatic. The classic red flags when taking a patient history should include:

  • Exertional angina,
  • Breathlessness,
  • Dizziness/syncope.

Any significant deterioration in functional exercise status within a 6 to 12 month period should raise concerns to referring clinicians.

“We need to dispel that the symptoms of aortic stenosis are not a normal part of ageing, even though many in the community are conditioned to think that these are simply signs of ageing.”

The second barrier for treating aortic stenosis is diagnosis.

“Auscultation of the heart is critical to aid in the diagnosis of this disease. The typical murmur of aortic stenosis is described as a high-pitched, “diamond-shaped” crescendo-decrescendo, systolic murmur. If a heart murmur is heard, it’s recommend a patient is referred to a cardiologist for further examination” Professor Martin Ng comments.

“We have an opportunity to reduce morbidity and mortality with early referral to a dedicated heart team.”

The traditional treatment option for aortic stenosis is open heart surgery or surgical aortic valve replacement (SAVR). An alternative option is transcatheter aortic valve implantation (TAVI). Specialised heart teams use a multidisciplinary approach to identify which treatment modality is best suited to each individual patient, be that a surgical option or a minimally invasive approach.

“TAVI has revolutionised the treatment of aortic stenosis. For people who aren’t suitable for surgery, TAVI has demonstrated safety and efficacy in patients who have been deemed as high risk surgery candidates. It has also shown effectiveness for patients who have been classified as being at intermediate risk for surgery,” explains Professor Martin Ng.

  1. American Heart Association, 2019
  2. J AM Coll Cardiol 2013- Sept 10;62 (11) 1002-12 Onsabrugge RL