What is Aortic Stenosis?

The word Aortic is derived from aorta, the main artery that pumps blood to the body from the heart. Additionally, the Greek translation of narrow is stenos.  In aortic stenosis, the aortic valve narrows, restricting blood flow from the heart to the body.

Most people are born with three leaflets of tissue over each artery that open and close as the heart beats. If someone is born with two leaflets, they may have premature narrowing of the valve. People with three valves often do not develop aortic stenosis until their 70s or 80s. Unfortunately, we can expect an increase in patients with aortic stenosis as baby boomers approach this age.

Common symptoms of aortic stenosis include:

–        Shortness of breath

–        Chest pain (often increasing with activity)

–        Fainting

–        Weakness

So, what is the science behind these symptoms? Simply put, as the aortic valve narrows, pressure increases inside the left heart ventricle. The left heart ventricle then becomes thicker, decreasing blood flow and causing chest pain. As the pressure continues to rise, blood may back up into the lungs, leading to shortness of breath. If you have a severe form of aortic stenosis, blood may not be able to reach your brain or other parts of your body as easily, causing fainting and weakness.

Typically, diagnosis starts with history-taking and a physical examination. We listen to the heart for a characteristic murmur that signifies a turbulent flow of blood across the narrow valve, and then perform an ultrasound to confirm the diagnosis.

For over 30 years, open heart surgery was the only way to treat aortic stenosis. Emory is the first hospital in the Southeast to study a non-surgical treatment called transcatheter aortic valve implantation.  It involves replacement of the narrow valve with a better-functioning synthetic valve from outside the body. We create a small incision in the groin or chest wall and then feed a wire mesh valve through a catheter, or tube, placing it where the new valve is needed. This technique may extend the lives of many people who are too ill or too frail to endure open-heart surgery.

In our next Heart and Vascular blog post, we’ll delve into more detail about procedures and technology surrounding aortic stenosis.

If you’re concerned that you may have aortic stenosis, we strongly encourage you to contact your physician for a physical. If you have further questions or comments regarding aortic stenosis or any other related condition, be sure to let me know in the comments section below.

Peter Block, MD has been practicing at Emory since 2000, where he specializes in internal medicine and cardiology. His areas of interests include angioplasty, cardiovascular disease, arteriosclerosis, and valve disease. Dr. Block’s major and/or recent publications focus on topics such as Equivalence Trials, Images in Clinical Medicine, and Short-Term Folic Acid Supplementation.

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  • Kaley Harbin

    I have had this condition since birth and have had open-heart surgery to correct it when I was 3. I am now 22 and wondering about my condition as an adult. Does open-heart surgery correct this condition permanently? Or is there going to be upkeep in my later years?

    • Dr. Block

      Hi Kaley,

      Thanks for your feedback. The outcome for aortic valve surgery in early life is variable from person to person, and not predictable. Certainly a careful follow up should be done to evaluate whether the surgery is still having a good effect. Most testing is done non-invasively with an ultrasound and can follow deterioration if it happens. If it does occur, repeat surgery may be needed.

  • John

    Are there rehab specialists or nutritionist, Physical therapist etc working on intensive programs to delay the narrowing of the aortic valve or is there nothing a patient can do?

    • Dr. Block

      Hey John, There are no known treatments to change the progression of aortic stenosis. Many medications have been tried but none have shown scientific evidence of effectiveness in trials. The variability of progression from individual to individual makes the rapidity of progression (or lack thereof) impossible to predict. -PB