Of the four valves in the heart, the most common problem occurs with the valve controlling blood flowing out of the heart into the major artery – the aorta. McLeod Cardiothoracic Surgeon Scot C. Schultz, MD, explains the problem, symptoms and the need to catch the problem early:
Here’s a summary of Dr. Schultz’s remarks:
The aortic valve sits right in the middle of the heart. Most of us have three leaflets on the valve opening that are made up of thin pieces of tissue. The leaflets come together in the middle and prevent the valve from leaking. When the heart pumps, the valve leaflets open and you get a wide-open area about the size of a nickel, maybe even a quarter.
Healthy leaflets should be virtually paper thin. You can almost see through them. When they become diseased and stenotic, calcium and debris develop on the leaflets. Rather than opening up to the size of a nickel or a quarter, sometimes it is difficult to get the tip of a pencil through the valve. That’s how tight and stenotic, or narrow, they can become. The calcium becomes very dense, very hard, kind of like concrete,
The way that we make the diagnosis of a narrowed or stenotic valve is typically with a stethoscope. We listen to your chest and hear what’s called a murmur. The murmur implies that there’s turbulent flow across that valve.
Unfortunately, there are no preventive measures. Lipid-lowering agents don’t seem to work. Aspirin doesn’t seem to work. Even worse, there’s no medication or medical therapy that’s effective in treating this disease. The only real way to treat this mechanical problem is to replace or implant a new valve.
The most common symptom of aortic stenosis is angina or chest pain. The next most common symptom is light-headedness. Some people even pass out. A more advanced stage is congestive heart failure. Blood backs up into the lungs or the rest of the body, because the heart can no longer pump the blood out of that tight valve.
It’s important to know that once you develop congestive heart failure due to aortic stenosis, your life expectancy is less than two years. When symptoms first begin to develop, we consider you a candidate to have something done surgically. The good news is that following valve replacement life expectancy returns to normal.
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