Aortic valve stenosis

Introduction

Aortic valve stenosis is a narrowing of the heart valve, which lies between the left ventricle of the aorta, the aortic valve. It is the most common heart valve defect in Germany. One consequence of the disease is usually an overload of the left heart, which initially leads to an enlargement of the heart muscle (hypertrophy) and finally to heart failure (cardiac insufficiency).

There are some characteristic symptoms of aortic valve stenosis, although these usually only occur in an advanced stage. A physician can diagnose aortic valve stenosis using imaging techniques. Depending on the stage of the disease, both conservative and surgical treatment options are possible.

Causes

While in children and adolescents congenital malformations or acute diseases are usually the cause of stenosis (narrowing), in adults so-called degenerative processes, or wear and tear, are usually responsible for aortic valve stenosis. This means that different processes in the body can lead to a more or less severe loss of function of the aortic valve. As a rule, changes in the vessels and the valve in the course of arteriosclerosis are the reason for the development of aortic valve stenosis.

This is a calcification of the vessels and the aortic valve, the cause of which has not yet been fully clarified. However, genetic predisposition and eating habits as well as stimulants (e.g. smoking) are suspected to be mainly responsible for the changes. This topic could also be of interest to you: Aortic Stenosis

Symptoms

Symptoms often appear only in the late course of aortic valve stenosis. The human body can easily compensate for a slight narrowing of the aortic valve, which is why minor aortic valve stenoses rarely become symptomatic in everyday life. The most common symptoms include the following: Severe narrowing of the aortic valve is often associated with heart failure and can cause characteristic symptoms.

For example, loss of consciousness (fainting) and dizzy spells may occur. Breathing difficulties and pain in the chest or lower jaw are also important indicators of the presence of aortic valve stenosis. Symptoms of aortic valve stenosis may also include a chesty cough, rattling noises when breathing, an increased breathing rate and water retention.

  • Dizziness
  • Breast tightness/angina pectoris
  • Heart failure
  • Atrial fibrillation
  • Pulmonary Edema

Dizziness can be one of the early signs of aortic valve stenosis. The narrowing caused by aortic valve stenosis results in reduced blood flow. As a result, the brain, among other things, is undersupplied and dizziness and sometimes syncope, i.e. a brief loss of consciousness, occurs.

These symptoms occur mainly during physical exertion, as the arteries are dilated in order to supply the muscles with sufficient oxygen, but at the same time the blood pressure drops. Angina pectoris is the name given to sudden chest pain. These occur when the blood flow to the heart is reduced or completely absent.

In aortic valve stenosis, the heart must contract more strongly due to the narrowing of the aorta in order to expel enough blood. As a result, the heart muscle grows (hypertrophy) and consequently requires more oxygen and thus a higher blood supply. Thus, even in healthy coronary arteries, an undersupply and thus angina pectoris can occur.

A cardiac insufficiency, also known as cardiac insufficiency, means that the heart is no longer able to pump the blood volume required by the body per minute into the circulation. Various symptoms can then occur, such as shortness of breath, dizziness, increased drowsiness, coughing or even pulmonary oedema. Heart failure occurs in aortic valve stenosis because the heart has to pump against a greater resistance due to the narrowing, and thus the muscle of the left ventricle grows.

As a result, it is able to cope with the greater resistance. After some time, however, the chamber (dilatation) widens due to the high pressure and the pumping power drops. Then it comes to heart failure.

Arrhythmias, i.e. cardiac dysrhythmias such as atrial fibrillation, can occur, especially in severe aortic valve stenosis. The increased pressure causes the left heart to grow and dilate. This constant pressure on the left ventricle causes atrial fibrillation.

Atrial fibrillation increases the risk of thrombus formation and thus the risk of suffering a stroke. The therapy is carried out by removing the aortic valve stenosis. In addition, blood-thinning medication is given to reduce the risk of stroke and in some cases a pacemaker is inserted.

Pulmonary edema is a complication of aortic valve stenosis. The increased pressure in the heart leads to an enlargement of the left chamber and ultimately to heart failure. Since the heart can no longer effectively supply the body with blood, fluid retention occurs.

Fluid accumulates in tissues and organs because not enough is excreted. This accumulation of fluid is called edema. On the one hand, they occur on the legs or in the abdomen.

On the other hand, they also occur in the lungs. Symptoms of pulmonary oedema are shortness of breath, coughing, foamy sputum, an increased heart rate, blue discoloration of the skin (especially lips) and restlessness, even fear of death. Pulmonary edema can be life-threatening and therefore requires treatment as soon as possible.

Aortic valve stenosis is a narrowing in the outflow area of the left ventricle. This constriction causes an increased pressure which the left ventricle has to overcome in order to pump the blood into the circulation. Over time, the heart muscle of the left ventricle grows.

This can compensate for the stenosis. However, in the long run the increased pressure is too much for the heart and the left ventricle is enlarged by dilatation. This causes the pumping capacity of the heart to drop and leads to heart failure. The heart is no longer able to discharge the required amount of blood to supply the body effectively. Symptoms such as oedema, shortness of breath or tiredness occur.