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Aortic stenosis

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There are some people who experience heart conditions despite living a perfectly healthy lifestyle. So, if you know you are eating right and you are keeping yourself active and yet you still experience occasional dizziness, chest pain or if you suffer from fainting spells, then maybe you have aortic stenosis. As you will understand later, you cannot really control the factors that will cause aortic stenosis. As a heart disease, aortic stenosis is specifically focused on the function of the aortic valve. The aortic valve is a trapdoor that shuts the pathway between the left ventricle and the aorta. A normal aortic valve will have three cusps or leaflets that serve as actual doors of the valve. Once the blood exits to the aorta, the cusps will come together, forming a lid or a blockade in the path thereby preventing a backflow of blood.

AORTIC STENOSIS SIGNS AND SYMPTOMS

In aortic stenosis, the opening of the aortic valve narrows. This situation makes it difficult for the blood to exit the ventricle and flow in to the aorta. Taking the analogy of the valve as a trapdoor, aortic stenosis is like having double doors but realizing that one is broken and sealed shut. You’d have to resort to using just one door and squeezing yourself inside. This is what happens to the blood – it squeezes itself into the narrowing aortic valve.

The narrowing of the valve constricts the blood flow. The body responds by making the heart pump harder. The left ventricle will exert too much effort trying to pump all the blood out through the valve and into the aorta. The ventricle grows thicker in order to keep up with the workload. Also, the blood flow becomes more turbulent. Because aortic stenosis affects a very specific part of the body, most people will probably wonder what activities could prevent a person from damaging his aortic valve. Unfortunately, there is not much you can do to prevent the disease. Fist of all, aortic stenosis may have congenital causes. There are people who are born with an aortic valve that has only two cusps, instead of three. This is called a bicuspid valve. These valves cannot open very widely and cannot shut very tightly, either. As what was mentioned, this condition will force the heart to pump way harder just to get more blood across the narrow valve. Over time, the excessive pumping will cause the valve to scar. The valve may also develop calcium deposits, giving further blocking to the already narrow valve.

AORTIC STENOSIS CAUSES

Meanwhile, for people over 65, senile calcific aortic stenosis is the main cause of aortic stenosis. Over the years, the turbulent blood flow and extreme pressure causes the protein collagen of the cusps/leaflets to wear out. Because of this, calcium gets deposited on the leaflets. Similar to bicuspid valves, this condition will lead to scarring and consequent narrowing of the valves.

Sometimes, this calcification of valves present in the elderly can also manifest along with a pre-existing condition of having only a bicuspid valve.
aortic stenosis
Image: Aortic Stenosis


Also, previous experience of rheumatic fever may also be the culprit for aortic stenosis. Rheumatic fever is a disease usually found in children ages five to fifteen. It is caused by an infection of the Group A streptococcal. It causes inflammation in the brain, joints, skin, and of course – the heart. Rheumatic fever causes the edges of the cusps to fuse together. Because of this, the cusps cannot close fully, thereby allowing some blood to flow back to the ventricle.

A person suffering from Aortic Stenosis will first and foremost feel chest pain (angina) , specifically in the upper abdomen area. This pain stems from the extreme effort that your left ventricle exerts just to get the blood flowing through the defective valve. The patient may also experience syncope or fainting spells. This is because a person with aortic stenosis will be unable to pump enough blood to respond to drops in the body’s blood pressure. There will be less blood supply to the brain and this will cause you to faint.

However, there is also a chance that the very first symptom is death itself. This happens in about 4% of the cases.

Because the condition is very serious, the person must go to the doctor as soon as he feels some of the symptoms.

AORTIC STENOSIS DIAGNOSIS

Usually, the doctor can make the diagnosis using an Electrocardiogram (EKG), which will assess the heart’s electrical activity. The EKG will be able to know whether the left ventricle thickened as a result of too much stress. A chest X-ray will also be useful. A doctor can also insert a catheter into a chamber of the heart so he can probe the heart’s true condition.

AORTIC STENOSIS TREATMENT

Once diagnosed, the patient can begin treatment. Mild to moderate aortic stenosis do not require much medical attention. However, severe cases will usually call for replacement surgery. The doctors may choose to replace the valve with a porcine (pig) or bovine (cow) valve which will not require the patient to be permanently on anti-coagulation and blood-thinning medication. However, if the patient and doctor want a more durable replacement, they may opt for mechanical prostheses. This replacement will require the patient to drink medication against coagulation and another medication for blood thinning – both for the rest of his life. This will ensure that blood clots don’t form on the surface and lead to further complications. For younger patients, doctors may opt for valvuloplasty – a procedure where a balloon is inserted into the valve, helping increase its opening.

However, the patient must also be very careful since they run a risk of developing infections in the valve. To prevent complications, people with aortic stenosis are advised to take antibiotic prophylaxis before any surgical, dental or medical procedures. Operations make provide further stress to the valve and to the heart so the patient must prepare his body. Also, he must be careful about any other medication that can affect his blood pressure.

If diagnosed and monitored effectively, this condition is completely treatable. Once you feel symptoms, contact your doctor immediately. Your heart is the muscle that pumps blood into your entire body. It is the only thing keeping you alive – take care of it.
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Medication commonly used for these disease:

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