The aorta is the largest and chief artery in the human body that supplies oxygenated blood throughout the system. This artery arises from the heart’s left ventricle and extends downwards up to the abdomen branching into two distinct arterioles called iliac arteries. The functioning capability of the aorta decreases as you grow older as the aortic muscles don’t expand or contract effectively adversely affecting smooth pumping out of blood and its circulation.
The channel and opening of the aortic valve become increasingly constricted thereby restricting convenient blood inflow as well as outflow. This narrowing of the valve and its orifice or opening that is medically known as ‘aortic stenosis’ reaches a peak usually when you’re in your sixties or seventies. Aortic stenosis in an advanced stage can lead to congestion of the artery eventually leading to a congestive heart failure. If you suffer from acute tightening of the aortic valve, you may need to go for its replacement via an open-heart surgery.
Causes of Aortic Stenosis
Aortic stenosis is a grave cardiac issue that affects large sections of the populace, both young and old. Though most individuals get bogged down from this heart problem when they become very old, more often than not, the issue is congenital. Following are the main causes of aortal stenosis:-
- Accumulation of mineral deposits
The bloodstream in the human body contains calcium as a natural or innate ingredient. Owing to its characteristic nature, calcium tends to crystallize and gets deposited inside the walls and leaflets of the aorta. The deposition process which is continuous (since blood is being circulated continually) leads to the accumulation of calcium, and after a certain period of time, becomes substantial enough causing arterial walls to become constricted ultimately hindering or restricting normal blood flow. In younger individuals, the narrowing starts happening much earlier owing to the discrepancy being acquired or inborn. Otherwise, the calcium buildup starts disrupting the circulation of blood only when one becomes 60 or 70-year old. Contrary to what many people think, calcium reinforced health drinks or capsules don’t contribute towards the mineral’s buildup.
- Hereditary issues
The majority of individuals usually have three flap-like triangular structures that open or shut the aortic valve alternatively. However, those with a congenitally imperfect valve, generally have less than or more than three flaps. So, an individual might be born with a unicuspid, bicuspid or quadricuspid valve (instead of having a tricuspid valve) if he or she has a hereditary issue. Normally, the anomaly or defect doesn’t come in the way of the valve’s functioning when the person is in his or her teens. The issue starts rearing its head once the individual becomes an adult, and the abnormality can be resolved or remedied by replacing or repairing the valve.
- Rheumatic fever
Rheumatic fever caused by streptococcus bacteria (the bacterium responsible for throat infection) can also lead to the aorta becoming stenotic or stenoted. The antibodies released by the body’s immune system for confronting the bacteria during a bout of rheumatic fever sometimes target the arterial tissues scarring them leading to the inflammation of the arteries. Calcium deposits start building up on the scarred surface resulting in stenosis in later years.
You’re unlikely to exhibit any symptom or symptoms if the narrowing or tightening is mild. It is only when the arterial passage becomes constricted enough to obstruct smooth blood flow (making the left ventricle struggle to siphon blood inside the artery) that the symptoms start getting palpable. Following are the usual symptoms or signs that can range from being severe to mild:-
- Heart murmur
- Angina (chest pain) resulting from deficiency of oxygenated blood in the coronary arteries
- Shortness of breath (difficulty to catch one’s breath after running up the stairs or any other strenuous physical activity)
- Swooning or fainting suddenly caused due to restricted and/or irregular blood supply
These symptom or symptoms if they become extreme often lead to CHF and heart attacks. Signs that an aortic stenosis patient is about to suffer a cardiac congestion or failure or already undergoing the same include swelling in the feet or ankles, shortness of breath, and tiredness or exhaustion. However, it sometimes happens that a patient doesn’t experience or feel any signs rendering diagnosis quite difficult. If by chance, the patient reports for a routine checkup, the physician might be able to pick up murmurs that usually transpire well before other symptoms start developing.
Whether you’ve aortic stenosis or not can be diagnosed when you visit a doctor after you’ve experienced a symptom that prevented you getting on with your routine activities. The physician usually puts a stethoscope to your heart and checks for anomalous heart sounds (murmurs). If he suspects that the murmurs are indicative of aortic stenosis, then he may recommend you for the following one or more diagnostic tests:-
- ECG (electrocardiogram)-An ECG diagnosis where wired patches are stuck to the skin surface in order to record and display electrical impulses of heart beats on a monitor screen helps the diagnostician to evaluate whether you’ve the condition or not
- Echocardiogram-Via an echocardiogram test, the physician is able to establish whether the valves of your heart are functioning normally or not. A transducer shaped like a wand is positioned on the heart which then processes the reflected sound waves into digital images.
- Chest X-Ray-A radiological examination of the chest including an x-ray helps the doctor to check-out the size of the left ventricle (that’ll be inflated if you’ve aortic stenosis), observe calcium deposits, and review lung condition.
Medicines can only offer you relief from the symptoms and that also on a temporary basis. Medications can never normalize blood flow in the aorta and the only option for reversing aortic stenosis is to go for surgery. However, the doctor may not immediately recommend a surgery the moment he detects the condition.
He’ll rather advise echo cardiogram tests every three or four months. Only after he’s convinced that your stenosis is acute or severe will he recommend carrying out a surgery. Usually, balloon valvuloplasty, aortic valve replacement surgery, surgical valvuloplasty, and transcatheter aortic valve replacement procedures are conducted.
Once your doctor establishes that you’ve aortic stenosis, he’ll recommend preventative techniques to avoid over straining your heart that may lead to heart failure.