Dr. M.J. Bazos, MD
Patient Handout
AORTIC VALVULAR
STENOSIS
About Your
Diagnosis
Aortic stenosis is narrowing in the aortic
valve, where blood leaves the left ventricle and enters the aorta. This
narrowing causes the left ventricle to do more work. Like other muscles in the
body forced to work hard, the ventricle thickens to generate more force. The
abnormality in the valve may have several causes. Among young persons, it is
usually from congenital abnormalities (those present at birth). Some persons are
born with damaged valves or have a two-sided (bicuspid) aortic valve instead of
a normal, three-sided valve. Aortic stenosis may occur among 1% to 2% of the
population. Rheumatic fever from streptococcal infections early in life or heart
disease such as cardiomyopathy may damage the valve and affect normal or damaged
valves later in life. The most common cause is calcium and cholesterol deposits
on the valve that occur as we age. Aortic stenosis is about three times more
common among men than among
women.
Living With Your
Diagnosis
Most persons with aortic
stenosis have no symptoms early. If the valve narrows enough to create flow
problems, you may have fatigue, fainting, chest pain, or symptoms of left heart
failure, such as shortness of breath. As the left ventricle thickens, that side
of the heart enlarges. A chest radiograph (xray) shows this abnormality. Your
doctor hears a heart murmur in a specific area over the heart. A murmur is a
sound made by the flow through an abnormal valve. An echocardiogram (ultrasound
examination of the heart) is obtained to confirm the diagnosis and check the
severity of the stenosis. If you have no symptoms, the condition merely is
checked each year. Because abnormal valves may be the target of some bacterial
infections, you should take antibiotics as prescribed before and after dental or
surgical procedures. If the stenosis is mild, you may exercise moderately
without many difficulties. If the stenosis is moderate or severe or there are
symptoms, you need to limit your exertion because overexertion can worsen
symptoms quickly. You may need medications to help control the symptoms
of
heart failure or arrhythmias that may
occur. An operation to replace the valve may be
necessary.
Treatment
The
best treatment is to take all medications prescribed and to closely monitor for
changes in symptoms. Antibiotics are necessary before and after dental or
surgical procedures. Diuretics reduce the excess fluid in the blood. Taking
diuretics may cause dehydration or electrolyte problems. Vasodilator medicines
such as nitrates reduce the workload of the heart. These drugs may cause
headaches or symptoms of low blood pressure such as fainting or lightheadedness.
Digitalis (digoxin) used for heart failure helps the heart contract better. The
level of this drug in the blood must be measured periodically with a laboratory
test.
The
DOs
•Take your medications as
directed.
•Stop
smoking.
•Start a salt-restricted
diet and lose weight if you have congestive heart
failure.
The
DON’Ts
•Do not neglect
worsening symptoms.
•Do not forget to
take your antibiotics before and after dental or surgical
procedures.
When to Call Your
Doctor
•If easy exercise is
becoming difficult. Rest until evaluated by your
doctor.
•If symptoms of heart failure
or heart disease occur, such as chest pain, shortness of breath, palpitations or
rapid heartbeat, or fainting.