All About Aortic Stenosis

Also known as aortic valve stenosis or aorta stenosis, it is a condition that affects the heart’s performance in pumping blood to the rest of the body. When blood is not circulated properly, your body may not get enough oxygen to function. This may result in symptoms such as breathlessness, tiredness, and dizziness, among others.

The heart relies on four valves to ensure that blood flows in the right direction. One of these valves is called the aortic valve which consists of three thin leaflets, or flaps, that open and close to regulate the blood flow from our heart to the entire body.

If you are diagnosed with aortic stenosis, these flaps become stiff and the aortic valve opening becomes narrow. This results in the flaps not being able to open and close fully like normal. In addition, the narrowing of the opening prevents your heart from pumping blood efficiently.

Aortic stenosis is a common heart valve disease in Malaysia that affects the elderly.

How Aortic Stenosis Develops

Valve disease can develop due to various factors such as congenital heart defect (i.e. bicuspid aortic valve), rheumatic fever, or radiation therapy.

However, in Malaysia, aortic stenosis is prevalent among the elderly. The ageing process can lead to an excess deposit of calcium which hardens the valve flaps. This can prevent the flaps from opening and closing properly, restricting the ability of the heart to pump sufficient amounts of blood to the rest of the body.

How Aortic Stenosis Progresses

Aortic stenosis can be either mild, moderate, or severe. Only your doctor can determine the stage of the disease, and it all depends on when the disease was detected and the extent of the damage to the aortic valve.

Those with mild and moderate aortic stenosis may not even be aware that they have a damaged heart. During these early stages of the disease, the decrease in blood flow may not be pronounced and thus symptoms are not immediately obvious.

However, since aortic stenosis is a progressive disease, the condition only worsens with time. Eventually, the heart muscles weaken from having to exert more force to circulate blood throughout the body. This happens because as the flaps stiffen even more, the opening of the aortic valve becomes narrower, making it harder for the heart to pump blood through the narrowed valve to deliver the needed amount of oxygen to the entire body.

Aortic stenosis can be life-threatening if left to the severe stage without any medical intervention. Symptoms of severe aortic stenosis may include breathlessness or tiredness. As such, it’s critical to seek professional medical care when these symptoms are present.

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References

  1. Bouma BJ, van den Brink RBA, van der Meulen JHP et al. To operate or not on elderly patients with aortic stenosis: the decision and its consequences. Heart 1999 Aug; 82: 143–8.

  2. Nikomo VT, Gardin JM, Skelton TN et al. Burden of valvular heart diseases: a population–based study. Lancet 2006;368:1005–11.

  3. Baumgartner H, Falk V, Bax JJ et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease: The Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2017; 38:2739–91.