Severe Aortic Stenosis: Definition, Causes, Progress, Symptoms and Treatment

Your heart works hard every second of the day, pumping the required amount of blood throughout your body.

It has four valves that play an important role in this process, one of which is called the aortic heart valve .

The aortic valve has thin sheets of tissue that open and close when the heart beats to regulate blood flow. Sometimes the aortic valve leaflets become stiff, causing a narrowing of the aortic valve opening.

This means that the valve cannot fully open and close as it should. As the opening gets smaller, it makes it harder for the heart to pump blood, which can affect your health.

This condition is called severe or severe aortic stenosis (also called aortic valve stenosis or aortic stenosis).

When the leaflets of your aortic valve do not open fully, your heart must work harder to push blood into your body.

Aortic stenosis is more common in men than women.

Causes of severe aortic stenosis

There are 4 main causes of aortic stenosis:

Calcium buildup

In most older adults, aortic stenosis is caused by a build-up of calcium (a mineral found in the blood) in the valve leaflets.

Over time, this causes the brochures to stiffen, reducing their ability to open and close completely.

Birth defects

A normal aortic valve contains three leaflets. But sometimes people are born with an aortic valve that has one, two, or four leaflets.

When defects are present, the aortic valve can leak and this can cause valve problems.

Rheumatic fever

Sometimes strep throat can lead to rheumatic fever that can lead to scar tissue forming in the heart. When this happens, the aortic valve may not be able to open and close as it normally should.

Radiation therapy

Some people can develop inflammation and scar tissue after receiving radiation therapy. This can make the aortic valve stiff and unable to function properly.

How does aortic stenosis progress?

Aortic stenosis is a progressive disease, which means that it will get worse over time. Because of this, doctors will generally measure it as mild, moderate, or severe aortic stenosis. The stage of aortic stenosis depends on how damaged your aortic valve is.

In the mild and moderate stages of aortic stenosis, the decrease in blood flow is usually not significant enough to cause external symptoms.

In fact, many people do not know they have the condition or may tell you that they have a heart murmur during a routine checkup.

The American College of Cardiology and the American Heart Association recommend that people with mild aortic stenosis have an echocardiogram every 3 to 5 years and people with moderate aortic stenosis have an echocardiogram every 1 to 2 years.

As the leaflets become more damaged, the opening of the aortic valve narrows more and the heart muscle weakens. Once your aortic stenosis becomes severe, you may notice uncomfortable symptoms such as shortness of breath or fatigue.

When this happens, it can be life-threatening, so it is important to tell your doctor as soon as you think you have symptoms or if they get worse.

After the onset of symptoms, patients with severe aortic stenosis have a survival rate as low as 50% at 2 years and 20% at 5 years without aortic valve replacement.

Dangers of severe aortic stenosis

The dangerous thing about severe aortic stenosis is that it prevents blood from flowing easily throughout the body. Your heart may have to work harder to pump blood throughout your body, and many times, it cannot do it effectively.

When that happens, some people may notice uncomfortable symptoms like shortness of breath and fatigue as the heart weakens.

Aortic stenosis is a common condition that affects about 1 in 8 people over the age of 75.

Here are some of the main reasons severe aortic stenosis is dangerous:

By the time it is found in many patients, the disease has progressed to an advanced stage. That’s why doctors call it severe aortic stenosis. The aortic valve has a severe build-up of calcium and has a hard time opening and closing.

Patients with severe aortic stenosis may find it difficult to participate in regular activities such as walking to receive mail or climbing stairs.

When this happens, your risk of heart failure increases significantly. This is why the prospect of severe aortic stenosis is worse than many cancers that have metastasized in the body, such as metastatic breast cancer and even lung cancer.

Severe aortic stenosis has a worse prognosis than many metastatic cancers.

Without aortic valve replacement, only a few people with the disease survive more than 5 years. The good news is that there is hope and a less invasive treatment option for severe aortic stenosis.

If you experience symptoms, or if you think you have severe aortic stenosis, talk to your doctor.

Recognize the symptoms of severe aortic stenosis

If aortic stenosis is so severe, why aren’t more people aware of it?

Many simply mistake these symptoms of aortic valve stenosis for normal signs of aging. But in reality, these symptoms may mean that your body is not getting enough oxygen.

Over time, you may feel tired and weak. These may be signs that your severe aortic stenosis has reached a life-threatening point.

Studies have shown that while many patients initially report no symptoms, upon closer examination 32% have symptoms. 4 This is why talking to your doctor about your symptoms is so important.

People may notice symptoms like:

  • Short of breath.
  • Chest pain.
  • Fatigue (low energy).
  • Dizziness, lightheadedness, and / or fainting.
  • Difficulty exercising.
  • Swollen ankles and feet
  • Fast or irregular heartbeat

Up to 50% of people who develop symptoms of severe aortic stenosis will die within an average of two years if their aortic valve is not replaced.

Symptoms of aortic valve disease are often misinterpreted by patients as normal signs of aging. If the person you care for is experiencing symptoms such as lack of energy, or is unable to do things as before, you should speak to a doctor immediately.

Don’t wait to treat your severe aortic stenosis.

If you have been told that you have severe aortic stenosis and you have symptoms, it is important to remember that medications cannot stop or cure the disease, they can only treat the symptoms. Valve replacement is the only effective treatment option.

That can be difficult to hear if you have received a recent diagnosis and are going through a variety of emotions. You may feel nervous or disbelieving. You may feel hesitant. Or you may want to wait and see how things go.

But if you have been told that you have severe aortic stenosis and you begin to experience symptoms, it is important that you get treatment right away. Call your doctor as soon as you notice these symptoms or if your symptoms get worse.

Open heart surgery is not the only option for treating severe aortic stenosis. Transcatheter Aortic Valve Replacement (TAVR) is a less invasive alternative to replacing your aortic valve. Explore your treatment options now.

Treatment options for aortic stenosis

Taking the next step in finding out about aortic stenosis treatment can be overwhelming, but it’s important to talk with your doctor about the options available to you.

Once your aortic stenosis becomes severe and you begin to have symptoms, prompt treatment is important. Your doctor may recommend balloon valvuloplasty (BAV) to relieve the symptoms of severe aortic stenosis.

However, it is not a durable solution, as the valve will eventually narrow again.

The only effective way to treat severe aortic stenosis is by replacing your valve. This can be done through a transcatheter aortic valve replacement (TAVR) or open heart surgery.

Explore Aortic Valve Replacement Options

Transcatheter Aortic Valve Replacement (TAVR)

TAVR may be an option if you have been diagnosed with severe aortic stenosis and are at intermediate or higher risk of having open heart surgery.

TAVR is a less invasive way to replace your aortic valve without requiring open heart surgery.

During the TAVR procedure, a small tube is used to insert a bioprosthetic valve into your diseased valve.

The TAVR procedure can shorten your recovery time so you can resume your normal activities.

Talk to your doctor about questions you may have about TAVR and / or its associated risks.

Open heart surgery

Also known as surgical aortic valve replacement. Usually during open heart surgery, the surgeon will make an incision the full length of your chest to access your valve.

Sometimes open heart surgeries can be done through smaller incisions (called minimal incision valve surgery).

Your aortic valve will be removed and a new one will be placed in your body. The new valve can be a mechanical valve or a bioprosthetic valve.

Talk to your doctor about questions you may have about open heart surgery and / or its associated risks.

Can medication treat severe aortic stenosis?

Depending on how much your aortic stenosis has progressed, your doctor may prescribe medication at first to help you manage your symptoms. But it is important to remember that eventually the valve will need to be replaced.