Aortic Valve Stenosis

Aortic valve stenosis refers to the narrowing of the valve present between aorta and left ventricle in heart. Narrowing prevents the valve from opening fully, and this reduces the flow of blood through the blood vessel. The heart compensates for the reduced flow by pumping harder.

This strains and weakens the muscles of heart. Aortic valve stenosis may develop as a congenital problem, or due to scarring of the valve. Many people do not experience any symptoms of stenosis. Symptoms gradually develop when the blood flow is restricted considerably.

Echocardiogram and cardiac catheterization are the diagnostic tests used for valve stenosis. Severe form of stenosis requires heart valve replacement.

Symptoms of Aortic valve stenosis depend on the extent of narrowing of the aortic valve. Mild narrowing remains without any symptoms for years. When the narrowing is significant, it creates increased pressure within the ventricle.

The major symptoms of aortic valve stenosis are:

• Angina or chest pain
• Fainting
• Shortness of breath
• Fatigue with increased physical activity
• Heart palpitations
• Heart murmur

As the muscles of heart weaken, it may lead to heart failure. This is characterized by shortness of breath, weakness, and swelling in ankles and feet.

Aortic valve stenosis is caused by the narrowing of the aortic valve. This may be due to: 

• Congenital heart disease – some children are born with aortic valves containing two flaps instead of three. This condition is called as bicuspid aortic valve. Presence of bicuspid valve increases the susceptibility of developing aortic valve regurgitation.
• Calcium build-up – Heart valves may accumulate calcium on the leaflets of valves. Calcium deposits stiffen the valve resulting in narrowing of the opening.
• Rheumatic fever – it is a common illness during childhood caused by strep infection. Rheumatic fever affects heart valves by scarring.

Making a diagnosis of Aortic valve regurgitation is done by several tests.

Review of medical history, family history, and physical examination provide important clues about the risks of developing this condition. ECG plots the electric impulses indicating the heart rhythm. Exercise test is used to assess the response of heart to exertion.

Echocardiogram and chest X-ray are also used in the diagnosis of the condition. Cardiac catheterization, a procedure in which a dye is injected into the blood vessel to plot leakages in blood vessel, is also prescribed. A more detailed picture of the heart and aorta is obtained by cardiac MRI.

Several methods are used for treatment of Aortic valve stenosis.

Surgical repair or replacement of the aortic valve helps to open the passage and ease the flow of blood. Medications are used to alleviate symptoms of the condition. Mild to moderate forms of stenosis may not require surgery.

Careful monitoring and evaluation of the risk factors help to keep the condition under check. Echocardiogram is recommended once every three years for mild stenosis. Surgery is needed only when the narrowing is severe. Methods to repair or replace the valve include:

Balloon valvuloplasty – in this procedure, a catheter is inserted into the blood vessel and guided to the damaged aortic valve. Once in position, the balloon is inflated which stretches the opening of the valve. This method is used to treat stenosis in infants and children. This procedure is not recommended for adults as the valve may become narrow again.

Valve replacement – in this method the damaged valve is replaced with a tissue or mechanical valve to enable smooth flow of blood into the blood vessel. Metal valves are durable, but has a risk of developing clots. After a mechanical valve replacement, warfarin, an anticoagulant, is recommended to prevent the formation of blood clots. Tissue valves are obtained from human donors or animals like cows and pigs. In some cases, one’s own pulmonary valve is used in place of damaged valve.

Surgical valvuloplasty – this is used to treat stenosis in infants where the leaflets of the aortic valve are fused together.

Medications – medications are prescribed to reduce accumulation of fluid, reduce heart rate, and also to control disturbances in heart rhythm.

Aortic valve stenosis can be prevented by:

• Preventing rheumatic fever
• Controlling risk factors of coronary heart disease
• Maintaining good dental hygiene

Patients with mild stenosis should restrict physical activity to prevent strain on heart.

Alternative remedies help to alleviate the symptoms of aortic valve stenosis. Digitalis, kalmia, lithium Carbonate, Naja, Rhus Tox, Spigelia, Spongia, Aconite, Adonis Vernalis, Amyl Nitrosum, Arsenic Album, Arsenic Iod, Aurum Mur, Baryta Carb, Cactus, Calcaria Carb, Cheledonium, Crotolus H, Gloninum, Kali Carb, Kali Iod, Lachesis, Lycopodium, Strophanthus Hispidus, Apis Mel, and Apocynum are used in homeopathy to control aortic regurgitation.

Fish oil with omega-3 fatty acids is considered to be good for controlling heart diseases. Coenzyme Q10 helps to maintain healthy blood vessels. It also supports optimal functioning of the muscles of heart.

Lifestyle modifications are necessary in order to cope with Aortic valve stenosis.

Controlling blood pressure, having a healthy diet, maintaining a healthy body weight, regular exercise, and regular check-ups are the best self-management tips for controlling symptoms of aortic valve disease.

Aortic valve stenosis may lead to several complications like angina, fainting, heart failure, arrhythmias, and cardiac arrest.