Structure & Function of the Heart:
Risk factors for Coronary Artery disease:
Coronary Artery Disease:
Emergency Complications of Heart Attack:
Coronary Artery Bypass Grafting (CABG):
Rheumatic Fever and Heart Valve Diseases:
Heart Transplantation and Assisted devices
Aortic Valve Stenosis
Aortic valve stenosis is a narrowing of the aortic valve which is located between the left ventricle and the aorta (biggest artery coming out of the heart)
What are the causes of aortic valve stenosis or narrowing?
Acquired (Degenerative) Aortic Stenosis: Most common cause of aortic valve stenosis in adults. This problem happens as a part of the aging process in some individuals. Calcium starts to deposit on the valve leaflets. As a rslt the valve is hardened and will not open properly resulting in aortic stenosis. Sometimes the valve becomes very hard as a stone.
Congenital Aortic Stenosis: The aortic valve is normally formed of three leaflets. In this condition, you are born with an aortic that has 2 leaflets only (Bicuspid Aortic Valve). The abnormal structure of the aortic valve induces abnormal and turbulent flow, which traumatizes the leaflets and leads to fibrosis and calcification. Calcifications progress to produce clinically evident aortic stenosis by the age of 50 or 60.
Rheumatic Aortic Stenosis: This is caused by rheumatic fever and represents the least common form of aortic stenosis in the adult population. Rheumatic aortic valve stenosis is rarely an isolated disease, and usually occurs in conjunction with mitral valve stenosis.
What happens as a result of this Aortic Stenosis?
Stenotic aortic valves cause stress on the left ventricle, which is forced to work harder to push blood through the narrowed opening. As a result, the ventricular heart muscle will thicken, or hypertrophy, until it actually outgrows its blood supply. Finally, the left ventricle will no longer be able to force enough blood past the valve. In this case, the heart itself may begin to fail, and patients usually start to develop symptoms. Severe left ventricular hypertrophy causes significant associated changes in coronary blood flow. Abnormalities in coronary blood flow will lead to chest pain or angina.
Symptoms and signs
1. Electrocardiogram: can detect abnormal patterns of the thickened left ventricle
2. Chest X-Ray: Normal in most patients with aortic stenosis. Can show the increased thickness of the left ventricle
4. Cardiac Catheterization: Coronary angiography is indicated in patients undergoing aortic valve replacement who are suspected to have coronary artery disease.
Grading The Degree Of Aortic Stenosis: The normal area of the adult aortic valve measures on average 3.0 to 4.0 cm2. Currently accepted criteria for the grading of aortic stenosis are:
Treatment decisions are largely based on the absence or presence of the symptoms, rather than on the size of the aortic valve area.
Antibiotic prophylaxis against infective enodocarditis will be advised before you have any surgical or dental procedure.
If you develop Heart failure, you will be prescribed a diuretic.
Percutaneous aortic balloon valvuloplasty: in which your valve can be widened using cardiac catheterization. This is usually useful in patients in whom surgery can be life threatening.
Surgical Treatment in the form of aortic valve replacement:
There are three main classifications of artificial valves:
Bioprosthetic valves are from animals (for example, the Hancock and Carpentier Edwards valves) specially treated with chemicals to avoid rejection.
Mechanical valves are made of metal, carbon and/or synthetics (for example, the St. Jude valve). Anticoagulation is required to prevent blood clots.
Biologic valves are human heart valves obtained from donors after death and frozen for later use (homograft). In the Ross procedure, the patient’s own pulmonary valve replaces the diseased aortic valve and in turn is replaced by a homograft valve.
Symptoms and signs of heart disease:
NonInvasive diagnostic tests For heart disease:
Invasive Diagnostic Tests for heart disease:
Cardiac Arrythmias and Pacemakers:
MEDICAL DISCLAIMER: This information and advice published or made available through the cardiacsurgeryacademy.org web site is not intended to replace the services of a physician, nor does it constitute a doctor-patient relationship. Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should consult a physician in all matters relating to your health, and particularly in respect to any symptoms that may require diagnosis or medical attention. Any action on your part in response to the information provided in this web site is at the reader's discretion. Readers should consult their own physicians concerning the information on this web site. Cardiacsurgeryacademy.org makes no representations or warranties with respect to any information offered or provided on or through this web site regarding treatment, action, or application of medication. Cardiacsurgeryacademy.org is not liable for any direct or indirect claim, loss or damage resulting from use of this web site and/or any web site(s) linked to/from it.
All Rights Reserved -Copyright 2009-2010