Aortic Stenosis

Some patients with aortic stenosis are asymptomatic for years. The signs and symptoms given below are generally evident when the narrowing of the aortic valve is severe:

• Pain in the chest that worsens with activity
• Feelings of dizziness or fainting with activity
• Experience of shortness of breath and fatigue on exertion
• Palpitations or rapid heartbeats
• Decreased appetite and inability to maintain a normal weight, especially in children
• In worst cases, aortic stenosis may result in heart failure, with symptoms like extreme fatigue, difficulty in breathing, and swollen feet and ankles

If you have been experiencing any or a combination of the symptoms mentioned above, you must visit a hospital and get an appointment with a cardiologist. Treating medical conditions, especially cardiac problems, at the right time gives better outcomes.

The human heart has four valves whose function is to maintain blood flow in the right direction and prevent its flow in the opposite direction. These four valves include the bicuspid valve, tricuspid valve, pulmonary valve, and aortic valve. Each valve has flaps or cusps that open and close when the heart beats. Sometimes for pathological reasons, the valves fail to open and close properly, leading to reducing or blocking the blood flow.

In aortic stenosis, the aortic valve that lies between the left ventricle and the aorta does not open completely. The part through which the blood moves from the heart toward the aorta is narrowed or stenosed. Once this happens, the heart is required to beat harder in order to pump enough blood into the aorta, which can then be supplied to the rest of the body. The left ventricle does most of the work of the heart, so this, in case it works even harder, causing its wall to thicken and enlarge. This overburdening of work weakens the heart muscles resulting in heart failure and other serious problems.

• Congenital heart disease
  Some children are born with heart defects where the aortic valve has only two cusps when normally it should be having three. An aortic valve may have a single cusp or even four cusps in some rare cases. If your kid is suffering from these diseases, you must ensure regular checkups by a cardiologist. Usually, the valve defect does not cause any symptoms until adulthood, when the valve begins to narrow and may need repair or replacement.
• Calcium build-up around the valve
  Calcium is an electrolyte found in the blood which plays an important role in maintaining the electrical signal that coordinates the heart's function. As the aortic valve repeatedly comes in contact with the blood flow, calcium deposits can sometimes accumulate around it, giving rise to aortic valve calcification. This calcium deposition around the aortic valve occurs over a period of time and may not cause any symptoms until the person is 70 or 80. But, in people with congenital aortic valve defects, these calcium deposits cause stiffening of the aortic valve at a younger age.
• Rheumatic fever
  It is a sequelae of streptococcal throat infection, which may result in the formation of scar tissue in the aortic valve, which leads to narrowing of the valve and its stenosis. Rheumatic fever can damage multiple heart valves.

• Increasing age
• Congenital heart defects like a bicuspid aortic valve
• History of infections affecting the heart
• Presence of cardiovascular risk factors like diabetes, high cholesterol and hypertension
• Chronic kidney disease
• History of radiation exposure to the chest

• Heart failure
• Stroke
• Formation of blood clots
• Bleeding
• Arrhythmias or abnormal rhythm of the heart
• Endocarditis or infection of the heart valves
• Death

• Prevent rheumatic fever
  See your doctor and undergo the recommended laboratory tests whenever you have a sore throat. Untreated or inadequately treated streptococcal infection may lead to rheumatic fever, which is a contributing factor to developing aortic stenosis.
• Keeping coronary heart disease risk factors in check
  Hypertension, obesity, and high cholesterol levels are linked to a high incidence of heart diseases, including aortic valve stenosis. So, it would be best if you took measures to keep your blood pressure, cholesterol levels, and weight in check by taking medicines and following a healthy lifestyle.
• Take care of your dental health
  Endocarditis or infective heart disease is linked with gingivitis or infected gums. Endocarditis over time leads to the build-up of scar tissue in the heart valves causing them to narrow and aggravate stenosis.

To diagnose aortic stenosis, the doctor will review your medical history, evaluate your signs and symptoms, and conduct a complete physical examination, including looking for murmurs by placing a stethoscope on your heart. Clinical examination is not enough to establish a diagnosis of aortic stenosis. Certain laboratory tests need to be done.

• Electrocardiogram or ECG
  It is a painless test that detects and records the electrical activity of the heart using small sensors attached to the chest, arms, and legs. An ECG can reveal enlarged chambers of the heart, cardiac diseases and abnormal heart rhythms.
• Echocardiogram
  This test employs sound waves to produce images of the heart in motion. A device called a transducer is firmly pressed against the skin by a technician aiming ultrasound rays through the chest to the heart. The transducer records the sound wave from the heart, displays those on a monitor, and then a report on it is produced.
• Chest X-ray
  It helps to find out whether the heart is enlarged, which is a common finding in aortic valve stenosis. It can also show enlargement of the aorta and build-up of calcium on the aortic valve.
• Exercise tolerance test
  These tests help to find out if there are any signs and symptoms of aortic valve disease during physical activity. They also help determine the severity of your condition. If a person is unable to exercise, medications that have similar effects on the heart as does exercise may be given to perform the test.

Treatment for aortic valve stenosis depends on your symptoms and the severity of the condition, as revealed by the laboratory tests.

If your symptoms are mild or you are completely asymptomatic, only monitoring is recommended with regular checkups. Some healthy lifestyle changes and medications may be recommended by your doctor to relieve symptoms or reduce the chances of complications.

In severe cases of aortic stenosis, surgery may be needed to repair or replace the damaged aortic valve. It is usually performed by making an incision in the chest. However, less invasive approaches may be performed if you are medically fit to undergo those. The surgical options for aortic valve stenosis include aortic valve repair or replacement, balloon valvuloplasty, and transcatheter aortic valve replacement (TAVR). TAVR is a less invasive procedure and is done in patients who have an intermediate or high chance of developing complications from surgical aortic valve replacement.

If you are searching for the best hospital for the treatment of Aortic Stenosis in Navi Mumbai, your search is over. At Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai, we focus on treating the diseases of the heart with utmost care and expertise. Represented by the best cardiologists in the country, our Cardiac Sciences Department boasts a significant success rate in treating cardiac diseases by using invasive and minimally invasive techniques. Equipped with state-of-the-art medical technology, highly qualified and experienced staff, and the best Aortic Valve Stenosis treatment doctors in Mumbai, we have achieved an overwhelming triumph in this field in the recent past. We consider it a priority to treat all our patients with utmost dignity and compassion, giving them the care and respect they deserve.