Aortic stenosis is a progressive narrowing of the aortic valve, reducing blood flow from the heart. Common in older adults, it causes breathlessness, chest pain, and fainting on exertion. Diagnosis involves imaging and ECG. Severe cases may need surgery. Avoiding strenuous activity is essential, especially in symptomatic individuals.
Heart Anatomy The heart consists of four chambers, the two atria and two ventricles. The valve present between the right and left atria is known as the bicuspid valve (mitral valve) and the one between the left and right ventricles is called tricuspid valve. There is also a valve located in between the left ventricle and the aorta, known as the aortic valve.(Image: Canva)
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Definition of Aortic Stenosis A long-term progressive disease that results in the narrowing of the aortic valve is termed as aortic stenosis. This narrowing makes it difficult for the valve to open completely, thus reducing the amount of blood entering the large blood vessel known as the aorta.(Image: Canva)
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Severity and Age of Onset The normal area of the aortic valve is around 3-4 squared centimetres. However, critical aortic stenosis can develop when this area becomes less than 0.8 squared centimetres. The age at which this commonly occurs is 50 to 70 years, but it can also be seen in people after 40 years of age.(Image: Canva)
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Health Risks of Dyspnea Dyspnea, or breathlessness, is one of the three cardinal symptoms of aortic stenosis. The person is often asked when they become breathless, and it is often after exercising or any activity that can cause exertion. This is a result of the inability of the left ventricle to pump enough blood to the aorta.(Image: Canva)
Chest Pain and Angina Not only dyspnea, a person who has aortic stenosis may also experience chest pain after exercising. The mismatch in the oxygen demands of the body and the reduced supply by the heart can lead to angina (chest pain). A co-existing disease of the arteries of the heart can also cause this.(Image: Canva)
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What is Syncope and Hypotension Since the cardiac output is not able to meet the increasing demand of the body tissues in a case of aortic stenosis, the blood pressure may fall. This can result in a loss of consciousness after exercising (called exertional syncope). Pain while lying down is also seen.(Image: Canva)
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Heart Failure and Bleeding Disorders Aortic stenosis can also lead to heart failure, with symptoms like orthopnea and paroxysmal nocturnal dyspnea, where the person experiences a sudden shortness of breath and coughing, causing them to wake up in the middle of the night when they are asleep. They may also experience gastrointestinal bleeding due to bleeding disorders (with aortic stenosis).(Image: Canva)
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Clinical Signs A person who has aortic stenosis may have a pale skin, and an asthenic look. Changes may also be seen in the pulse and the blood pressure by the healthcare provider. A certain heart murmur may be heard using a stethoscope, due to the presence of a diseased valve.(Image: Canva)
Investigations and Treatment To confirm this condition, a chest X-ray may be advised, along with an electrocardiogram (ECG) and an echocardiography. A cardiac magnetic resonance and cardiac CT may be recommended. Surgery may be needed in some cases, especially those who have symptoms.(Image: Canva)
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Precautions Persons with aortic stenosis must avoid vigorous physical activity, as this may worsen the pre-existing condition. This must especially be avoided in those who have a severe aortic stenosis. If one does not have any symptoms, irrespective of the severity, the prognosis is likely better than those with symptoms.(Image: Canva) Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis
Rajeshwaari Kalla is a freelance health and wellness writer
