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Aortic Valve Stenosis

Causes and its Aggravating Factors


Causes
Aortic valve stenosis is narrowing of the aortic valve. Many things can narrow this
passageway between your heart and aorta. Causes of aortic valve stenosis include:

Congenital heart defect


The aortic valve consists of three tightly fitting, triangular-shaped flaps of tissue called
leaflets. Some children are born with an aortic valve that has only one (unicuspid), two
(bicuspid) or four (quadricuspid) leaflets not three. This deformity may not cause any
problems until adulthood, at which time the valve may begin to narrow or leak and may
need to be repaired or replaced.
Having a congenitally abnormal aortic valve requires regular evaluation by a doctor to
watch for signs of valve problems. In most cases, doctors don't know why a heart valve
fails to develop properly, so it isn't something you could have prevented.

Calcium buildup on the valve


With age, heart valves may accumulate deposits of calcium (aortic valve calcification).
Calcium is a mineral found in your blood. As blood repeatedly flows over the aortic valve,
deposits of calcium can accumulate on the valve's leaflets. These deposits may never
cause any problems. These calcium deposits aren't linked to taking calcium tablets or
drinking calcium-fortified drinks.
However, in some people particularly those with a congenitally abnormal aortic valve,
such as a bicuspid aortic valve calcium deposits result in stiffening of the leaflets of the
valve. This stiffening narrows the aortic valve and can occur at a younger age. However,
aortic valve stenosis that is related to increasing age and the buildup of calcium deposits
on the aortic valve is most common in men older than 65 and women older than 75.

Rheumatic fever.
A complication of strep throat infection, rheumatic fever may result in scar tissue forming
on the aortic valve. Scar tissue alone can narrow the aortic valve and lead to aortic valve
stenosis. Scar tissue can also create a rough surface on which calcium deposits can
collect, contributing to aortic valve stenosis later in life.
Rheumatic fever may damage more than one heart valve, and in more than one way. A
damaged heart valve may not open fully or close fully or both. While rheumatic fever is
rare in the United States, some older adults had rheumatic fever as children.

Age-related calcification of the valve


This is a common cause. Deposits of calcium build up in the valve in some older people. It is
not clear why this happens. This calcification makes the valve stiff and open less easily. It
can be mild and cause little narrowing. However, in time it can become more severe. About
1 in 20 people aged over 65 have some degree of this type of aortic stenosis.

Other causes of Aortic Valve Stenosis


Other causes of aortic stenosis are uncommon and include:

Some congenital heart problems. It is then usually part of a complex heart deformity.
Infection of the valve (endocarditis).
An abnormality of the tissues just above or just below the valve. This may cause a
narrowing and restrict blood flow, and cause problems identical to stenosis of the
valve.

In adults, three conditions are known to cause aortic stenosis.


1.
2.
3.

Progressive wear and tear of a bicuspid valve present since birth (congenital).
Wear and tear of the aortic valve in the elderly.
Scarring of the aortic valve due to rheumatic fever as a child or young adult.

If you have mitral stenosis and shortness of breath during any sort of activity that
requires effort, you might want to avoid extremely strenuous physical activity. Many
people with confirmed aortic stenosis become winded with any sort of
physical activity. THEREFORE, ITS WISE TO AVOID STRENUOUS PHYSICAL
ACTIVITY OR EMOTIONAL UPSET WHEREVER POSSIBLE. BOTH CAN INCREASE
HEART RATE, AND AGGRAVATE ALREADY SLOWED BLOOD FLOW AS THE RESULT
OF THE VALVE NARROWING. Your doctor may also recommend that you follow a nosalt diet to avoid fluid overload, since extra fluid that flows backward to the lungs can
worsen breathing problems.

SOME POSSIBLE WAYS TO PREVENT AORTIC VALVE STENOSIS INCLUDE:


1. Taking steps to prevent rheumatic fever
You can do this by making sure you see your doctor when you have a sore throat. Untreated
strep throat can develop into rheumatic fever. Fortunately, strep throat can usually be easily
treated with antibiotics. Rheumatic fever is more common in children and young adults.
Causes of Sore throat includes:
Most sore throats are caused by viruses that cause the common cold and flu
(influenza). Less often, sore throats are due to bacterial infections.

Other causes of sore throat include:

Allergies. Allergies to pet dander, molds, dust and pollen can cause a
sore throat. The problem may be complicated by postnasal drip, which can irritate and
inflame the throat.

Dryness. Dry indoor air, especially in winter when buildings are heated,
can make your throat feel rough and scratchy, particularly in the morning when you first
wake up. Breathing through your mouth often because of chronic nasal congestion also
can cause a dry, sore throat.

Irritants. Outdoor air pollution can cause ongoing throat irritation. Indoor
pollution tobacco smoke or chemicals also can cause chronic sore throat. Chewing
tobacco, drinking alcohol and eating spicy foods also can irritate your throat.

Muscle strain. You can strain muscles in your throat just as you can
strain them in your arms or legs. Yelling at a sporting event, trying to talk to someone in a
noisy environment or talking for long periods without rest can result in a sore throat and
hoarseness.

Gastroesophageal reflux disease (GERD). GERD is a digestive system


disorder in which stomach acids or other contents of the stomach back up in the food pipe
(esophagus).

Other

signs

or

symptoms

may

include

heartburn,

hoarseness,

and

regurgitation of stomach contents and the sensation of a lump in your throat.

HIV infection. A sore throat and other flu-like symptoms sometimes


appear early after someone is infected with HIV. Also, a person who is HIV-positive may have
a chronic or recurring sore throat due to a secondary infection. Common problems include a

fungal infection called oral thrush and cytomegalovirus infection, a common viral infection
that can be serious in people with compromised immune systems.

Tumors. Cancerous tumors of the throat, tongue or voice box (larynx) can
cause a sore throat. Other signs or symptoms may include hoarseness, difficulty swallowing,
noisy breathing, a lump in the neck, and blood in saliva or phlegm.
Rarely, an infected area of tissue (abscess) in the throat causes a sore throat. Another rare
cause of a sore throat is a condition that occurs when the small cartilage "lid" that covers
the windpipe swells, blocking airflow (epiglottitis). Both causes can block the airway,
creating a medical emergency.
2. Addressing risk factors for coronary artery disease. These include high blood
pressure, obesity and high cholesterol levels. These factors may be linked to aortic
valve stenosis, so it's a good idea to keep your weight, blood pressure and
cholesterol levels under control if you have aortic valve stenosis.
3. Taking care of your teeth and gums. There may be a link between infected gums
(gingivitis) and infected heart tissue (endocarditis). Inflammation of heart tissue
caused by infection can narrow arteries and aggravate aortic valve stenosis.