Aortic stenosis
Overview
Aortic stenosis is a cardiovascular condition characterized by the narrowing of the aortic valve opening. This restricts blood flow from the left ventricle to the aorta, and subsequently to the rest of the body. Aortic stenosis can be congenital (present at birth) or can develop later in life due to other health conditions or factors.
Etiology
The most common causes of aortic stenosis include congenital heart defects, rheumatic fever, and calcific aortic stenosis. Calcific aortic stenosis, the most common form in adults, is caused by progressive calcium deposition on the aortic valve, leading to its stiffening and narrowing.
Pathophysiology
In aortic stenosis, the narrowing of the aortic valve opening restricts the flow of blood from the left ventricle to the aorta. This results in increased pressure within the left ventricle, leading to left ventricular hypertrophy (enlargement and thickening of the heart muscle). Over time, this can lead to heart failure.
Clinical Manifestations
Symptoms of aortic stenosis may not appear until the condition has advanced significantly. Common symptoms include fatigue, shortness of breath, chest pain, fainting, and heart palpitations. In severe cases, aortic stenosis can lead to heart failure, presenting symptoms such as swelling of the ankles and feet, rapid weight gain due to fluid retention, and difficulty breathing while lying flat.
Diagnosis
Diagnosis of aortic stenosis typically involves a combination of physical examination, patient history, and diagnostic tests. Physical examination may reveal a heart murmur, indicative of abnormal blood flow. Diagnostic tests may include electrocardiography (ECG), echocardiography, and cardiac catheterization.
Treatment
Treatment for aortic stenosis depends on the severity of the condition. In mild cases, regular monitoring and lifestyle modifications may be sufficient. In more severe cases, surgical intervention may be required. This can involve aortic valve replacement or a less invasive procedure known as transcatheter aortic valve replacement (TAVR).
Prognosis
The prognosis for aortic stenosis varies depending on its severity and the patient's overall health. With appropriate treatment, many individuals with aortic stenosis can lead a normal life. However, untreated severe aortic stenosis can be life-threatening.
Epidemiology
Aortic stenosis is a common heart condition, particularly among older adults. It is estimated that 2-9% of individuals over the age of 65 have some degree of aortic stenosis.