The aortic valve is located on the left side of the heart and controls blood flow out of the left ventricle, the heart chamber responsible for pumping blood into the large artery that shares this supply with the rest of the body — the aorta. Aortic stenosis affects the aortic valve, preventing it from working effectively and reducing the heart's ability to transfer blood and oxygen. Over time, this can lead to serious complications.
Over time, a build-up of calcium can develop in the aortic valve, causing the valve to narrow and making the tissue less supple. The narrowing and stiffening of the valve eventually interrupts proper functioning, affecting the flow of blood from the left ventricle to the aorta and the amount of pressure in the heart.
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The most common cause of aortic stenosis is a build-up of calcium forming on the valve. The blood naturally contains calcium, which can account for the stiffening. However, some cases of aortic stenosis stem from a congenital heart defect called a bicuspid aortic valve. In addition, a previous bout of rheumatic fever can lead to the condition, as can radiation therapy.
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Aortic stenosis is a progressive illness. When doctors review a person with aortic stenosis, they categorize his or her condition as mild, moderate, or severe. People with mild or moderate aortic stenosis are unlikely to experience symptoms and may be misdiagnosed with a heart murmur. When the stenosis becomes severe, symptoms are inevitable; this life-threatening stage requires urgent medical intervention.
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Once the disease has progressed significantly, people with aortic stenosis often experience breathlessness and pain or discomfort in the chest. They may also become aware of a pounding heartbeat and have palpitations. Aortic stenosis can also cause fainting. Everyday activities become more difficult and cause lethargy.
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Almost all babies or children with aortic stenosis have the congenital form of the disease. The symptoms of aortic stenosis in children are different from those in adults. Infants and children are likely to become extremely tired, and sometimes dizzy or lightheaded, during physical exercise and play. They may struggle to gain weight at a healthy or expected rate, as the disease can cause difficulties with feeding. Children with this condition may also have difficulty breathing.
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People over the age of 60 are most at risk for developing aortic stenosis, though due to the lack of early symptoms, individuals may not feel any symptoms for a decade or more. Very rarely, a child's aortic valve does not grow at the same rate as his or her heart. This leads to calcium build-up in the narrowed valve at a far younger age.
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When the aortic valve narrows due to aortic stenosis, blood cannot be pumped throughout the body as effectively. This reduces the amount of available oxygen, and the heart has to work harder and harder to circulate blood adequately. As the condition becomes more severe, the person becomes less able to carry out their day-to-day activities, and, over time, the weakening of the heart muscles can lead to heart failure.
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Often, people with aortic stenosis do not require any immediate treatment. Instead, the doctor will continue to carefully observe the progression of the condition through regular checkups. Before the physician makes this decision, she will administer an echocardiogram, a test that allows her to see the exact state of the patient's heart valve — even symptom-free people may have more severe aortic stenosis than symptoms suggest.
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Severe aortic stenosis requires prompt surgical treatment to prevent further damage to the heart. One option is a balloon valvuloplasty, which involves inserting a surgical balloon into the heart with a catheter. The balloon is inflated, widening the aortic valve. This is a short-term solution; the valve opening will gradually narrow again. Alternatively, doctors may suggest a complete replacement of the aortic valve. Although this is major surgery, it is a more long-term solution for people with aortic stenosis.
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One way to help prevent aortic stenosis is to treat throat infections promptly. Strep throat can become rheumatic fever, which raises the risk of developing stenosis. Maintaining proper dental hygiene and care is also important; experts have established a link between gum disease and aortic stenosis. Any factors that increase the risk of developing heart disease, such as obesity and high cholesterol levels, also increase the risk of aortic stenosis, so a healthy diet and lifestyle can lower the likelihood of the condition developing.
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