Aortic stenosis
Aortic stenosis is a narrowing of the aortic valve and / or the area immediately around it.
The aorta is the main artery that takes freshly oxygenated blood from the heart to the rest of the body.
To prevent blood flowing the wrong way from the aorta back into the left ventricle, there is a valve at the exit point where the aorta meets the heart. This is the aortic valve.
Narrowing of the aortic valve is caused by a build-up of calcium on the inner wall of the valve, and tends to develop slowly as we get older.
When the components of the aortic valve thicken and harden, the valve no longer opens properly, restricting the flow of oxygenated blood out of the heart and into the aorta.
To compensate, the heart has to work harder to ensure the body receives adequate blood flow. There is also pressure build-up in the heart as it cannot expel enough blood through the aortic valve.
Initially there may not be symptoms as the heart compensates. However, as aortic stenosis progresses, patients may experience:
- chest pain or a feeling of pressure/tightening in the chest, spreading out to arms, shoulders, neck and stomach
- breathlessness during moderate to strenuous activity
- blackout during exertion when the heart is working hard.
These symptoms are identical to coronary heart disease symptoms: a cardiologist will check for aortic stenosis.
Aortic stenosis is most common in older people but some younger people born with a heart defect may also have the condition.
Diagnosis and treatment
Aortic stenosis is usually diagnosed with an echocardiogram.
It is not possible to reverse aortic stenosis through lifestyle changes, however quitting smoking, maintaining a healthy weight and eating a good diet helps to reduce strain on the heart during treatment.
Patients should seek advice from a cardiologist or doctor to determine an appropriate level of physical activity.
We cannot treat aortic stenosis with medication. If it is serious enough to require treatment, there are three options.
Surveillance
The valve may not be narrow enough to need surgery
Non-invasive valve replacement (TAVI/TAVR)
Transcatheter aortic valve implantation (TAVI) involves inserting a catheter into a blood vessel in the upper leg or chest, and passing it towards the aortic valve.
Valve replacement surgery
The decision to replace the valve is based on the patient's symptoms, general health, and how well their heart is working.
The procedure is typically open-heart surgery: the new valve may be made from metal or animal tissue.
Open-heart surgery is a serious procedure and patients typically need a week in hospital and two to three months off work to recover.
Links
Contact us
John Radcliffe Hospital
Oxford, OX3 9DU
Linda Dequental: 01865 223735
Email: linda.dequental@ouh.nhs.uk