Aortic Stenosis

What is aortic valve stenosis?

Aortic (ay-OHR-tik) valve stenosis (ste-NOH-sis) is also called aortic stenosis or AS. It is a disease of the aortic valve in the heart. Valves act as doors between the heart chambers (rooms). They open and close to direct blood flow through the heart. The aortic valve lies between the left ventricle (lower chamber) and the aorta.

The aorta is a blood vessel that supplies blood to your head and your body, including the heart muscles. The aortic valve is made up of three cusps (flaps) attached to the aortic ring. The cusps come from the sides and top of the valve and meet in the middle. As the heart beats, the aortic valve opens to let blood flow into the aorta. When the heart rests between beats, the aortic valve should close to keep blood from flowing back. Aortic stenosis happens when the cusps get thicker and stiffer. Stenosis means the valve opening gets smaller. When you have aortic stenosis, your heart works harder to push blood through the thick, stiff aortic cusps. Over time, the cusps cannot open wide enough to allow adequate blood to flow from your heart into your aorta.

What causes aortic valve stenosis?

Some people with aortic stenosis were born with a problem with the aortic valve in their heart. The valve may have one or two cusps instead of three. The cusps may be deformed and only partly close.

As people get older, calcium can build up and make the cusps thicker and stiffer. This leads to AS. An infection called rheumatic fever may also cause heart valve damage and AS.

What are the signs and symptoms of aortic valve stenosis?

Both children and adults can have aortic stenosis. Often there are no signs of the disease until you are 40 years or older. The most common signs and symptoms of aortic stenosis are:

• Chest pain.
  
  
• Dizziness.
  
  
• Fainting.
  
  
• Shortness of breath during exercise or activities like climbing stairs.

Other symptoms may include:

• Fast and irregular heart beat.
  
  
• Fatigue (feeling tired more than the usual).
  
  
• Heart murmur (abnormal heart sound) when caregivers listen to your heartbeat.
  
  
• Trouble breathing especially when lying flat or with just one pillow. You may be awakened from sleep due to trouble breathing.

How is aortic valve stenosis diagnosed?

You may have one or more of the following tests:

• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Cardiac catheterization: This is a procedure done to find the cause of and treat a heart condition. A thin, bendable tube inserted into an arm, neck, or groin vein is moved into your heart. Your caregiver may use an x-ray to guide the tube to the right place. Dye (contrast) may be put into your vein so the pictures show up better on a monitor.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Echocardiogram: This test is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart.

How is aortic valve stenosis treated?

Treatment of aortic stenosis depends on your symptoms. You may have one or more of the following treatments:

• Surgery: Surgery is the only treatment to cure aortic stenosis. The procedures may include an aortic valve replacement, aortic valve repair or aortic balloon valvuloplasty. Ask your caregiver for more information about these procedures.
  
  
• Medicines: Medicines are given to prevent further damage to the aortic valves that may lead to other problems. Other medicines may be given to treat symptoms.
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Aspirin: This medicine may be given to help thin the blood to keep blood clots from forming. This medicine makes it more likely for you to bleed or bruise.
    
    
  • Cholesterol medicine: This type of medicine is given to help decrease (lower) the amount of cholesterol (fat) in your blood.
    
    
  • Diuretics: This medicine is given to decrease edema (excess fluid) that collects in a part of your body, such as your legs. Diuretics can also remove excess fluid from around your heart or lungs and decrease your blood pressure. It is often called water pills. You may urinate more often when you take this medicine.
    
    
  • Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.

What can I do to feel better?

• Limit activity: Your caregiver may tell you not to exercise as much or as hard as usual. This will depend on how bad your aortic stenosis is and your symptoms. You may have to decrease or stop doing some activities even if you do not have symptoms.
  
  
• Good nutrition for your heart: Get enough calories, protein, vitamins, and minerals to help prevent poor nutrition and muscle wasting. You may be told to eat foods low in cholesterol or sodium (salt). You also may be told to limit saturated and trans fats. Do eat foods that contain healthy fats, such as walnuts, salmon, and canola and soybean oils. Eat foods that help protect the heart, including plenty of fruits and vegetables, nuts, and sources of fiber. Ask what a healthy weight is for you. Set goals to reach and stay at that weight.

How do I find support and more information?

Having aortic valve stenosis is a life-changing disease for you and your family. Accepting that you have aortic stenosis may be hard. You and those around you may feel scared, confused and sad. These feelings are normal. Talk to your caregiver, family or friends about your feelings. You may also want to join a support group with other people who have aortic stenosis. Call or write the following organizations for more information:

• American Heart Association
  7272 Greenville Avenue
  Dallas , TX 75231-4596
  Phone: 1- 800 - 242-8721
  Web Address: http://www.heart.org
  

• National Heart, Lung and Blood Institute
  Health Information Center
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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