Aortic valve stenosis | Diseases of the aorta

Aortic valve stenosis

Aortic valve stenosis is a clinical picture of the heart in which the aortic valve is narrowed. In medicine, it is often referred to as aortic stenosis. The causes of aortic valve stenosis vary with age.

Most often, calcification of the valve occurs in older patients. If the stenosis occurs in younger people, it is usually caused by a congenital disorder of the valve. Furthermore, rheumatic fever can lead to aortic valve stenosis.

Due to the narrowing of the aortic valve, the heart has to pump against a stronger pressure to transport the blood from the heart into the body. As a result, the heart muscle becomes thicker and thicker (hypertrophy) and in the long term becomes weaker and is no longer able to supply the body with sufficient blood (heart failure). This is particularly evident in the form of shortness of breath, dizziness and angina pectoris. If these symptoms occur, the risk of dying is greatly increased, as the heart is already very much affected by the difficulty in pumping. Therefore, the therapeutic focus is then on the operation, in which the valve should be replaced in order to prevent further consequential damage.

Aortic isthmus stenosis

Aortic isthmus stenosis refers to a naturally occurring constriction between the left subclavian artery (Arteria subclavia sinsitra) and the ductus arteriosus, a connection in the bloodstream that is present during prenatal development. This connection is closed after birth, leaving behind a natural (physiological) constriction. If this is very pronounced, a pathological aortic isthmus stenosis (constriction) can develop, which is often congenital and can lead to considerable circulatory disorders with organ damage.

Atherosclerosis

Atherosclerosis describes a calcification of blood vessels, which can lead to changes in blood flow. It is not uncommon for the aorta to be affected. In this process, blood components, connective tissue, fats or even calcium are deposited in the vessel walls.

The disease develops over a long period of time and is often the result of malnutrition: These changes lead to a decrease in elasticity, i.e. the vessel becomes stiffer, which impairs the wind-vessel function. The vessel wall can also become narrower (stenosis) or wider (aortic aneurysm). The plaques that have formed can also tear open and lead to the formation of blood clots (thrombi). Such thrombi can constrict the blood vessel so that the blood flow is impaired or even become loose and get stuck in smaller vessels, which can lead to an infarction of the heart, brain or even abdominal organs. – High blood lipid values

  • Insufficient exercise
  • Obesity
  • High blood pressure
  • Diabetes
  • Smoking

Aortic valve insufficiency

Aortic valve insufficiency describes the inability of the aortic valve to close completely, resulting in a kind of small leak. As a result, the pressure that must be built up in the heart to pump blood effectively into the body can only be built up to a lesser extent. The whole thing hardly manifests itself at first, but in the long term it leads to an insufficiency of the heart muscle, as it tries to compensate for the aortic valve insufficiency and is not designed to do so in the long term.

The causes can be acute in the form of an infection (usually bacterial) or chronic in the form of congenital damage to the aortic valve. The decisive factor in therapy is whether symptoms are already evident. If this is not yet the case, heart failure can be treated with medication. If the affected person shows signs of chronic heart failure with, for example, an increased incidence of fainting (syncope), surgery should be attempted to reconstruct or replace the aortic valve depending on the extent of the valve failure.