Aortic stenosis
Alternate Names : Aortic valve stenosis, Left ventricular outflow tract obstruction, Rheumatic aortic stenosis, Calcium aortic stenosis
Treatment
If there are no symptoms or symptoms are mild, you may only need to be monitored by a health care provider. Patients with aortic stenosis are usually told not to play competitive sports, even if they don't have symptoms. If symptoms do occur, strenuous activity must be limited. Medications are used to treat symptoms of heart failure or abnormal heart rhythms (most commonly atrial fibrillation). These include diuretics (water pills), nitrates, and beta-blockers. High blood pressure should also be treated.
Patients should stop smoking and be treated for high cholesterol. People with aortic stenosis should see a cardiologist every 3 to 6 months. Surgery to repair or replace the valve is the preferred treatment for adults or children who develop symptoms. Even if symptoms are not very bad, the doctor may recommend surgery. People with no symptoms but worrisome results on diagnostic tests may also require surgery. Some high-risk patients may be poor candidates for heart valve surgery. A less invasive procedure called balloon valvuloplasty may be done in adults or children instead. This is a procedure in which a balloon is placed into an artery in the groin, advanced to the heart, placed across the valve, and inflated. This may relieve the obstruction caused by the narrowed valve. Children with mild aortic stenosis may be able to participate in most activities and sports. As the illness progresses, sports such as golf and baseball may be permitted, but not more physically demanding activities. Valvuloplasty is often the first choice for surgery in children. Some children may require aortic valve repair or replacement. If possible, the pulmonary valve may be used to replace the aortic valve. People with aortic stenosis should inform their health care provider of their condition before any procedures or surgeries. For example, dental work, including cleaning, and any invasive procedure, such as colonoscopy, can introduce bacteria into the bloodstream. These bacteria can infect a damaged heart valve. Although patients with valve problems are no longer automatically given antibiotics before any dental or other procedure, antibiotics may still be recommended in certain cases to help decrease the risk of infection and complications. See also:
Prognosis (Expectations)
Without surgery, a person with aortic stenosis who has angina or signs of heart failure may do poorly. Aortic stenosis can be cured with surgery. After surgery there is a risk for irregular heart rhythms, which can cause sudden death, and blood clots, which can cause a stroke. There is also a risk that the new valve will stop working and need to be replaced.
Complications
- Arrhythmias
- Endocarditis
- Left-sided heart failure
- Left ventricular hypertrophy (enlargement) caused by the extra work of pushing blood through the narrowed valve
Calling Your Health Care Provider
Call your health care provider if you or your child have symptoms of aortic stenosis. For example, call if you or your child have a sensation of feeling the heart beat (palpitations) for more than a short period of time. Also contact your doctor if you have been diagnosed with this condition and your symptoms get worse or new ones develop.
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