Severe Aortic stenosis can be lifethreatening 

Heart valves open when the heart pumps to allow blood to flow forward, and close quickly between heart beats to make sure blood does not flow backward. The aortic valve directs blood from the left lower chamber (left ventricle) into the aorta. Aorta is the major blood vessel that leads from the left lower chamber out to the rest of the body. Any disruption in this normal flow will make it difficult for the heart to effectively pump the blood where it needs to go.

Severe aortic stenosis (AS) occurs when the aortic valve doesn’t open properly. This forces your heart to work harder to pump blood throughout your body. Over time, the heart muscle weakens. This affects your overall health and keeps you from participating in normal daily activities. If left untreated, severe AS is a serious, life-threatening condition leading to heart failure and increased risk for sudden cardiac death.

The major reason that makes aortic stenosis such a deadly disease is that it may or may not produce any noticeable symptoms in many people until the amount of restricted blood flow falls to drastic levels. “The signs of aortic stenosis are chest pain, pressure or tightness, breathlessness, fainting, decline of activity level, palpitations or a feeling of heavy, pounding, or noticeable heartbeats and heart murmur.

It is important to watch out for these specific signs of, especially in elderly. In elderly patients, AS does not produce initial symptoms for a long time. And by the time they develop any of the typical symptoms including angina (chest pain or discomfort), syncope (fainting) or shortness of breath, life expectancy becomes limited. The only possible treatment at that stage is valve replacement,” says Dr Manoj K Agarwala, Director-Interventional, Cardiology, Apollo Health City, Hyderabad.

A serious life-threatening condition, severe aortic stenosis requires surgical intervention in most cases. Open heart surgery was the only available treatment options for aortic stenosis few years ago however the approach and outlook has significantly changed after the introduction of TAVR.
“Trans-catheter aortic valve replacement (TAVR) has emerged as an effective treatment option for symptomatic severe aortic stenosis in patients who are at high surgical risk.

TAVR is a minimally invasive aortic valve replacement procedure and offers many great advantages over standard treatment alternatives including open heart surgery for patients diagnosed with inoperable aortic stenosis. It is recommended for patients with high surgical risk to improve their survival and functional status. In addition, it is also recommended as an effective and comparatively safer procedure for individuals with multiple comorbidities and high risk for mortality,” concludes Dr Agarwala.

Since, AS generally does not produce symptoms till it gets moderate to severe, it is advised to go for regular check-ups to ensure early diagnosis. The prevalence of AS increases with age therefore elderly patients should particularly ask their physicians for valve functions test and seek information on the newer treatments available in case of severe aortic stenosis.

Risk Factors

Severe AS is often not preventable, causes narrowing of the aortic valve, and may be related to the following:

• Age
• A buildup of mineral (calcium) deposits that narrows the aortic valve (stenosis)
• Radiation therapy
• A history of infection of the heart(rheumatic fever)
• Increased fat in the blood vessels (high cholesterol)