What is Aortic Stenosis?
Aortic stenosis occurs when the aortic valve, located between the heart’s main pumping chamber (the left ventricle) and the body’s main artery (the aorta), narrows. This restricts blood flow from the heart to the rest of the body. The left ventricle must then work harder to push blood through the constricted opening. Over time, this increased effort can cause the heart muscle to thicken and weaken.
Defining Moderate Aortic Stenosis
Moderate aortic stenosis represents an intermediate stage, falling between mild and severe classifications. Diagnosis relies on specific measurements obtained through an echocardiogram, an ultrasound of the heart. These criteria include the aortic valve area (AVA) of 1.0 to 1.5 square centimeters (cm²), a mean pressure gradient across the valve usually between 20 and 39 millimeters of mercury (mmHg), and a peak jet velocity of 3.0 to 3.9 meters per second (m/s).
Common Causes and Symptoms
Aortic stenosis commonly develops due to age-related calcification, where calcium deposits accumulate on the valve leaflets, causing them to stiffen and narrow. This process is prevalent in older individuals, often appearing after age 60 and becoming symptomatic in their 70s or 80s. Another cause can be a congenital bicuspid aortic valve, a condition present at birth where the valve has two cusps instead of the usual three, which can lead to earlier narrowing. A history of rheumatic fever, a complication of untreated strep throat, can also damage heart valves and contribute to aortic stenosis.
Individuals with moderate aortic stenosis may experience no symptoms or only mild ones, particularly during normal daily activities. When symptoms do occur, they can include shortness of breath, especially with exertion, or chest pain. Fatigue, dizziness, or fainting, particularly during physical activity, are also possible indicators. The presence of increasing symptoms can suggest that the condition is progressing.
Diagnosis and Ongoing Monitoring
The diagnostic process for aortic stenosis often begins with a physical examination, where a healthcare provider listens for a heart murmur using a stethoscope. A heart murmur, an unusual sound during heartbeats, can be a sign of a valve problem. The primary tool for confirming and assessing aortic stenosis is an echocardiogram. This test uses sound waves to create images of the heart, allowing visualization of the valve and measurement of blood flow and pressure. Other tests, such as an electrocardiogram (ECG) to measure electrical activity, or a chest X-ray to check for heart enlargement, may provide supportive information.
For individuals with moderate aortic stenosis, a “watchful waiting” approach is often recommended. This involves regular follow-up appointments and repeat echocardiograms, typically every one to two years, to monitor the valve’s condition and detect any progression.
Managing Life with Moderate Aortic Stenosis
Managing moderate aortic stenosis involves a focus on heart-healthy lifestyle choices and consistent medical oversight. Maintaining a balanced, heart-healthy diet is beneficial for overall cardiovascular well-being. Regular, light to moderate exercise, when approved by a healthcare provider, can help maintain physical fitness without overstressing the heart. It is important to avoid strenuous activities that could place excessive demands on the heart.
Managing other cardiovascular risk factors, such as high blood pressure and elevated cholesterol, is also a component of care. Adherence to medical advice, including prescribed medications for related conditions, and attending regular check-ups are important for monitoring the condition and adjusting management strategies as needed. These proactive steps can help individuals live well with moderate aortic stenosis.