If left untreated, severe aortic stenosis can lead to heart failure. Intense fatigue, shortness of breath, and swelling of your ankles and feet are all signs of this. It can also lead to heart rhythm problems (arrhythmias) and even sudden cardiac death.
What Is the Main Cause of Aortic Stenosis? Aortic stenosis is most commonly caused by atherosclerosis, a calcium buildup on the aortic valve over time. These calcium deposits that often come with age make the valve tissue stiff, narrow and unyielding.
The 2020 ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease categorize aortic stenosis into four stages, including: risk of AS (Stage A), progressive hemodynamic obstruction (Stage B), asymptomatic severe AS (Stage C, with substages C1 and C2), and symptomatic severe AS (Stage D, with ...
Rapid haemodynamic progression
Although the average rate of progression (measured by peak aortic-jet velocity) is 0.24±0.30 m/s/year, this rate is highly variable.
As the valve becomes tighter, the pressure gradient across the valve increases. A pressure gradient >50 mmHg indicates severe disease.
According to the British Medical Journal, after symptoms appear, patients with severe aortic stenosis have a survival rate as low as 50% at 2 years – and 20% at 5 years – without aortic valve replacement. So timely treatment is critical if you exhibit symptoms.
Severe symptomatic aortic stenosis is associated with a poor prognosis, with most patients dying 2–3 years after diagnosis.
According to The Cleveland Clinic, catheterization and echocardiographic studies suggest that, on average, the valve area declines 0.1-0.3 square centimeters per year. The Cleveland Clinic also states that the systolic pressure gradient across the aortic valve can increase by as much as 10-15 mm Hg per year.
Aortic valve replacement is recommended for severe aortic stenosis if the patient has symptoms. It is also recommended if the left ventricular ejection fraction is less than 50%, if the patient is undergoing other cardiac surgery, or if symptoms arise on exercise stress testing.
The risk of sudden cardiac death in asymptomatic aortic stenosis is approximately 0.4% per year. Risk of sudden cardiac death in aortic stenosis is likely to be a complex interplay between several potential risk factors, including myocardial fibrosis and myocardial ischaemia.
Based on the severity of your condition, your doctor may limit your activity, but many patients can exercise and do most activities without restriction. However, you should increase activity or start an exercise or walking program only under the guidance of your doctor.
Both statins and ACE-Inhibitors have been shown to reduce the progression of atherosclerotic disease and to significantly improve the clinical outcome among patients with coronary artery disease.
Feeling faint or dizzy or fainting with activity. Shortness of breath, especially with activity. Fatigue, especially during times of increased activity. Rapid, fluttering heartbeat (palpitations)
The patient's history and physical examination are essential in diagnosing aortic stenosis. Identifying symptoms such as exertional shortness of breath, angina, dizziness, or syncope is important for proper management. The characteristic systolic murmur guides further diagnostic investigations.
Classic symptoms of aortic stenosis include dyspnea and other symptoms of heart failure, angina, and syncope. The onset of these classic symptoms indicates hemodynamically significant aortic stenosis and is a critical point for making management decisions. It is also important to recognize that presentations may vary.
Eat a variety of fruits and vegetables, low-fat or fat-free dairy products, poultry, fish, and whole grains. Avoid saturated and trans fat, and excess salt and sugar.
Aortic stenosis is one of the most common and serious types of heart valve disease. Aortic stenosis can be debilitating, costly, and deadly. Survival rates without treatment for severe symptomatic aortic stenosis are low at 50% at 2 years after symptom onset, and 20% at 5 years.
The aortic valve may need to be replaced for 2 reasons: the valve has become narrowed (aortic stenosis) – the opening of the valve becomes smaller, obstructing the flow of blood out of the heart. the valve is leaky (aortic regurgitation) – the valve allows blood to flow back through into the heart.
Finally, we discuss the optimal SBP level to reach in patients with aortic stenosis. Again, randomized trials are not available but observational evidence suggests that values between 130 and 139 mmHg systolic and 70-90 mmHg diastolic might represent the best option, and lower BP targets should probably be avoided.
Aortic valve replacement. During this surgery for aortic stenosis in the elderly, the surgeon replaces the damaged valve with a mechanical valve or a valve made from pig, cow, or human heart tissue. The aortic valve can also be replaced with the person's own lung valve. Transcatheter aortic valve replacement (TAVR).
Eat heart-healthy foods. These include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit sodium, alcohol, and sugar.
Risk factors for aortic stenosis include: risk factors for heart disease, like smoking, diabetes, high blood pressure, and high cholesterol. kidney disease. radiation therapy to the chest.
Statins but Not Angiotensin-Converting Enzyme Inhibitors Delay Progression of Aortic Stenosis.
Intense mental stress poses a considerable risk, particularly to patients with significant aortic stenosis. As described here, it can precipitate acute pulmonary edema.