Aortic valve stenosis: Causes, symptoms, complications

The article is professionally consulted by Prof. TS.BS Vo Thanh Nhan - Director of Cardiovascular Center, Vinmec Central Park International General Hospital.

Narrow aortic valve will impede the flow of blood containing oxygen and nutrients to other parts of the body. This is one of the four most common types of heart valve disease and has many dangerous complications if not detected and treated promptly.

The aorta is the largest artery in the body that carries blood from the heart to the whole body; is the part of the aorta located in the chest, in front of the spine, supplying blood to the heart, brain, head and neck, and spine. The normal size of the thoracic aorta increases with age and ranges from 2 to 3.5 cm.
The aortic valve is a valve separating the aorta and the left ventricle, it is responsible for closing during diastole to prevent blood from flowing back from the aorta to the left ventricle and opening during systole to pump blood from the left ventricle up. aorta into the circulatory system. If in case the valve is damaged for any reason, it will lead to incomplete closure during diastole causing aortic regurgitation, the valve does not fully open during systole, causing aortic valve stenosis.
Aortic stenosis (HC) is the most common cause of left ventricular ejection fraction obstruction. Other causes include fibrous subaortic stenosis, subaortic stenosis due to hypertrophic cardiomyopathy, and supraaortic stenosis. This is the most common valvular disease, accounting for a quarter of all heart valve disease cases with 80% of patients with aortic stenosis being men.

Some main causes of aortic stenosis:
Congenital aortic stenosis: Due to the abnormal structure of the heart valve since birth, such as mitral valve (accounting for 1-2% of the population) , mainly in men. People who are stuck with the leaflets, one-wing valves... Over time, the aortic valve often degenerates and calcifies earlier than normal people. Heart valve stenosis due to degeneration and calcification (most common in the elderly, most common 70 - 80 years old). Increasing age will cause the aortic valve to become disabled, cholesterol plaques to close in the heart valve, causing many cardiovascular problems including aortic valve stenosis. Due to rheumatic heart disease: rheumatic heart disease accompanied by mitral valve disease, rheumatic heart disease causes fibrosis, calcification, adhesions of the leaflets and valve edges of the aorta, thickening of the leaflet margins.

3.1. Functional symptoms These symptoms usually only appear when the stenosis of the aortic valve is severe:
Chest pain: As the myocardial oxygen demand increases, the heart muscle weakens due to the increased pumping of blood through the heart muscle. Heart valve narrowing after a long time. Chest pain due to coronary artery disease. Dizziness, syncope: This symptom occurs due to a fixed obstruction of the ejection path from the left ventricle, reducing the ability to increase cardiac output. The patient may experience a severe drop in blood pressure leading to dizziness or fainting. Heart failure: Due to dysfunction of systolic or diastolic function. Cardiac fibrosis leads to decreased contractility of the heart. Compensatory mechanisms to increase intravascular volume will increase left ventricular pressure, increase pulmonary capillary pressure causing pulmonary stasis. 3.2. Physical symptoms - palpation: The prominent symptom is the weak to slow pulse of the carotid pulse
- Palpable systolic fibrillation in the right II intercostal space. In addition, the apex of the heart can be palpated with a wide, diffuse beat if the left ventricle is enlarged.
- Auscultation: The main pathological sounds include
Systolic blow ejecting blood in the upper right side of the sternum, spreading to the neck and reaching the highest intensity in the head - mid-systole. The more severe the severity of the aortic stenosis, the longer, stronger, and slower peaking sounds T1 and T2 sounds do not change with aortic stenosis T3 sound is a sign of poor left ventricular systolic function. T4 occurs because the left atrium contracts to force blood into the left ventricular chamber, which is poorly dilated when the aortic valve is tight. In addition, murmurs of aortic regurgitation due to stenosis often accompany regurgitation Resting tachycardia in patients with severe aortic stenosis is one of the first signs of decreased cardiac output. short.

Is heart valve stenosis dangerous is a question that many people ask when unfortunately having aortic valve stenosis.
Aortic valve stenosis has many dangerous complications when it progresses to a severe stage
Infective endocarditis Ventricular arrhythmias: Extrasystoles, ventricular tachycardia, ventricular fibrillation Atrial fibrillation: Atrial fibrillation often causes causing episodes of acute heart failure due to loss of atrial compensatory contraction mechanism, reduced atrioventricular - ventricular outflow, decreased cardiac output Sudden death Vascular occlusion due to calcified fragments, atherosclerotic plaques, wart fragments... Acute coronary syndrome . The disease often progresses silently for many years before any obvious symptoms appear. High risk of death with symptoms
Chest pain: Survival rate is only 50% after 5 years. Syncope, dizziness: The survival rate is only 50% after 3 years. Heart failure: Survival less than 2 years. Aortic valve stenosis is a dangerous disease and can cause serious complications if not examined and treated promptly. Accordingly, to prevent heart valve stenosis, you need to have regular health checkups every 6 months, have a scientific and healthy lifestyle. When you are diagnosed with aortic stenosis, you need to have the right treatment process according to the advice of your doctor at reputable medical addresses.
Currently at Vinmec International General Hospital, there is a course of examination and treatment of aortic valve stenosis that is chosen by many patients. In particular, Vinmec can perform Percutaneous Heart Valve Replacement without surgery, with the advantages of being simple, gentle, and less invasive than conventional aortic stenosis surgery. Vinmec General Hospital is now the first hospital in Vietnam that can independently implement this method.