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Aortic Stenosis

Aortic Stenosis



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Published by: Khalid Mahmud Arifin on Jun 27, 2008
Copyright:Attribution Non-commercial


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Aortic stenosis
Alternative names
Aortic valve stenosis
The aorta is the large artery that originates in the left ventricle (lower chamber) of the heart. Aorticstenosis is the narrowing or obstruction of the heart's aortic valve, which prevents it from openingproperly and blocks the flow of blood from the left ventricle to the aorta.
Causes, incidence, and risk factors
As the aortic valve becomes more narrow, the pressure increases inside the left heart ventricle.This causes the left heart ventricle to become thicker, which decreases blood flow and can lead tochest pain. As the pressure continues to increase, blood may back up into the lungs and you mayfeel short of breath. Severe forms of aortic stenosis prevent enough blood from reaching the brainand rest of the body. Lightheadedness and fainting can result.Aortic stenosis may be present from birth (congenital), or it may develop later in life (acquired). Itis caused by many disorders. One common cause is rheumatic fever ,a complication of untreated strep throat. Calcification of the valve can also cause this condition. In this case, the condition isusually not seen until a person reaches their 70s.Aortic stenosis occurs in approximately 5 out of every 10,000 people. It is more common amongmen.
Fainting,weakness, or dizziness with activity
Breathlessnesswith activity
Sensation of feeling the heart beat (palpitations)
Chest pain, angina-type
Under the chest bone, may move to other areas
crushing, squeezing, pressure, tightness
Pain increases with exercise, relieved with restNote: Aortic stenosis may show no symptoms until late in the course of the disease.
Signs and tests
The health care provider will be able to feel a vibration or movement when placing the hand over the heart. A heart murmur, click, or other abnormal sound is almost always heard through astethoscope. There may be a faintpulseor changes in the quality of the pulse in the neck.A change in neck pulse is called pulsus parvus et tardus.Blood pressure may be low.
The following tests may be performedn:
Left cardiac catheterization
Transesophageal echocardiogram (TEE)
ECGThis disease may also alter the results of the following:
If there are no symptoms or symptoms are mild, you may only need to be monitored by a healthcare provider. If symptoms are moderate to severe, you may need to stay in the hospital.Medications can include diuretics, digoxin, and other medications to control heart failure.  Symptomaticpeople may be advised to avoid strenuous physical activity. People with symptomsof aortic stenosis (difficulty breathing, chest pain, fainting episodes) should have a physical examevery 6 to 12 months and an ECG performed every 1 to 3 years.Surgery to repair or replace the valve is the preferred treatment for patients who have symptoms.Some high-risk patients are poor candidates for heart valve surgery. A less invasive procedurecalled balloon valvuloplasty may be done instead. This is a procedure in which a balloon is placedinto an artery in the groin, advanced to the heart, placed across the valve, and inflated. This mayrelieve the obstruction caused by the narrowed valve.
Expectations (prognosis)
Aortic stenosis can be cured with surgery, although there may be a continued risk for arrhythmias,which can sometimes cause sudden death. The person may be symptom-free until complicationsdevelop. Without surgery, a patient who has signs of anginaor heart failure may do poorly.Persons with aortic stenosis, particularly moderate and severe forms, should not participate instrenuous activities, such as competitive sports.
Left ventricular hypertrophy (enlargement) caused by the extra work of pushing bloodthrough the narrowed valve

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