Author: Dr Mansi Turaga
What is aortic stenosis?
Aortic stenosis is one of the most common and serious valve disease problems.
Aortic stenosis is a condition where the aortic valve, which controls the flow of blood from the heart’s left ventricle to the aorta, becomes narrowed or obstructed. This narrowing restricts blood flow, causing the heart to work harder to pump blood into the aorta and to the rest of the body (1,2).
What are the causes of AS?
- Most common cause is age-related calcification
- Rheumatic heart disease
- Congenital– eg bicuspid aortic valve
Symptoms of severe aortic stenosis may include:
- Chest pain (angina)
- Trouble breathing or feeling short of breath (dyspnoea)
- Feeling dizzy or light-headed on exertion or sudden collapse (syncope)
- Difficulty walking short distances (fatigue)
- Decline in activity level or reduced ability to do normal activities
- Palpitations
Follow-up (5):
Mild AS – with GP for clinical review before considering repeat echocardiogram in 2-3 years
Moderate AS – 1-2 yearly echocardiogram and clinical review
Severe AS - 6 months-1 yearly echocardiogram and clinical review
Treatment options for symptomatic severe AS:
- Surgical aortic valve replacement
- Transcatheter valve replacement (TAVI) – will need TAVI CT for investigation prior
Severe aortic stenosis is a serious condition that requires prompt attention. If not properly managed, it can lead to significant cardiovascular complications. Research indicates that early diagnosis and appropriate intervention are critical for improving patient outcomes and quality of life (3,4). Timely management strategies are essential in addressing this condition effectively.
References and Further Reading
- https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/problem-aortic-valve-stenosis
- https://www.heartvalves.com/nz/general-practitioner
- Otto CM. Timing of aortic valve surgery. Heart. 2000;84:211-18.
- Malaisrie SC, McDonald E, Kruse J, et al. Mortality While Waiting for Aortic Valve Replacement. Ann Thorac Surg 2014;98:1564-71.
- APPROPRIATENESS GUIDELINE FOR ADULT ECHOCARDIOGRAPHY (NEW ZEALAND) A. Sasse, T. O’Meeghan, R. Anscombe, C. Goggin, N. van Pelt
- Barnhart GR, Martin RP, Thomas JD, McCarthy PM. The need for echocardiography alerts for aortic stenosis: the time has come. Journal of the American Society of Echocardiography. 2020 Mar 1;33(3):355-7. 5. 2021 ESC/EACTS Guidelines for the management of valvular heart disease, European Heart Journal (2022) 43, 561–632