Aortic Stenosis Quiz

Understanding Aortic Stenosis: An In-Depth Guide

Aortic stenosis (AS) is a common and serious valve disease problem. This guide provides an overview of its causes, symptoms, diagnosis, and treatment, complementing the knowledge tested in the quiz.

What is Aortic Stenosis?

Aortic stenosis is the narrowing of the aortic valve opening. This narrowing restricts the blood flow from the left ventricle to the aorta, the body’s main artery. As a result, the left ventricle has to work harder to pump blood to the body, which can lead to various complications over time, including heart failure.

Causes and Risk Factors

• Calcific Degeneration: This is the most common cause in older adults. Over time, calcium deposits build up on the valve leaflets, causing them to stiffen and narrow.
• Bicuspid Aortic Valve: A congenital condition where the aortic valve has two leaflets instead of the usual three. This can lead to AS earlier in life.
• Rheumatic Fever: Although less common now due to antibiotics, this complication of strep throat can cause scarring of the heart valves, leading to AS.

Symptoms of Aortic Stenosis

The classic triad of symptoms for severe aortic stenosis indicates a poor prognosis if left untreated. These include:

• Angina (Chest Pain): Discomfort or pressure in the chest, often occurring with exertion.
• Syncope (Fainting): Loss of consciousness, particularly during or after physical activity.
• Dyspnea (Shortness of Breath): Difficulty breathing, especially with exertion or when lying down.

Diagnostic Procedures

The primary tool for diagnosing and assessing the severity of AS is an echocardiogram (cardiac ultrasound). This non-invasive test allows doctors to visualize the aortic valve, measure the valve area, and assess blood flow velocity and pressure gradients across the valve. Other tests may include an electrocardiogram (ECG) and cardiac catheterization.

Staging and Severity

Aortic stenosis is typically staged based on hemodynamic measurements from the echocardiogram. Severe AS is generally defined by an aortic valve area (AVA) of less than 1.0 cm², a mean pressure gradient greater than 40 mmHg, or a peak jet velocity greater than 4.0 m/s.

Treatment Options for AS

Treatment depends on the severity of the stenosis and the presence of symptoms. For severe, symptomatic AS, valve replacement is the definitive treatment. Options include:

• Surgical Aortic Valve Replacement (SAVR): An open-heart procedure to replace the diseased valve with a mechanical or bioprosthetic valve.
• Transcatheter Aortic Valve Implantation (TAVI/TAVR): A less invasive procedure where a new valve is inserted via a catheter, typically through an artery in the leg. This is often preferred for older or high-risk patients.

This information is for educational purposes and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.