Medical terms can confuse. Take “Aortic Stenosis.” If you’re not sure what that means, you have considerable company. McLeod Cardiologist Neil Trask, MD, helps us understand this heart problem, its symptoms and treatments.
Here are highlights from Dr. Trask’s comments:
Aortic stenosis involves the heart’s aortic valve, one of the more important valves. This heart valve opens with the heart squeezes to allow blood to go out into the aorta. The aortic valve needs to open completely to the sidewalls of the aorta. When the ability to open all the way is limited or the valve opening narrows, it’s called stenosis. If the valve becomes too narrow, symptoms will appear.
Most of the time it is what we call an “acquired” condition, meaning something that you develop later in life. Yet, it can be “congenital,” meaning it’s apparent at birth. As people get older and the valve gets narrowed, there are three main symptoms. Typically, you will get short of breath with activity, develop chest discomfort or start feeling light headed or dizzy. Once those symptoms develop, it is time to act, because your outlook changes when you feel the symptoms.
If you develop chest discomfort related to the valve and you don’t do anything, something bad is going to happen in five years. Fainting is about the same. If you develop significant shortness of breath, you should do something soon, because most people will run into trouble in the next two years.
It would be nice if we had a Drano or some sort of compound that we could put into the blood stream to get rid of the calcium that forms in the valve and keeps it from opening. Yet, for now it remains a disease that needs surgical intervention. Traditionally, it’s open heart surgery where you make an incision in the middle bone of the chest, the sternum. In the last 5 or 10 years, a lot of heart centers are using minimally invasive surgery, where you might come in from the side and avoid separating the breast bone which is more uncomfortable and requires a longer recovery. In the last 10 years, specialists can replace the aortic valve non-surgically using a catheterization technique. A catheter is simply a tube that goes into the artery running up the leg to the heart. A valve is crimped on the end of the catheter. The surgeon and cardiologist work together in placing the new valve.
The advantage of this procedure: It seems to be better than surgery for high-risk patients. For medium-risk people, it may be better than traditional surgery. And currently, it’s being tested on average-risk people.