Aortic Valve Sclerosis - All About the Valve Obstruction

Creator: Dr. Niharicka Gopalakrishnan
Published: 2023-05-19T16:59:59

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Aortic valve sclerosis is a valvular heart disease in which the aortic valve thickens but does not entirely obstruct blood flow. Read the article to know more.

Written by

Dr. Niharicka Gopalakrishnan

Medically reviewed by

Dr. Muhammad Zohaib Siddiq

May 19, 2023

March 8, 2024

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Contents

What Is the Aortic Valve?
What Is the Function of an Aortic Valve?
What Is Aortic Valve Sclerosis?
Is Aortic Valve Sclerosis the Same as Aortic Stenosis?
What Are the Signs and Symptoms Associated With Aortic Valve Sclerosis?
What Are the Risk Factors Associated With Aortic Valve Sclerosis?
How Is Aortic Valve Sclerosis Diagnosed?
What Is the Treatment for Aortic Valve Sclerosis?
What Are the Complications Associated With Aortic Valve Sclerosis?
What Are the Signs and Symptoms Associated With Aortic Valve Stenosis?

What Is the Aortic Valve?

The heart comprises four valves that regulate blood flow, and the aortic valve is one of them. Having three sections or leaflets (the left, right and posterior), the aortic valve separates the ascending aorta from the left ventricle (lower left chamber), which is the heart's main pumping chamber.

What Is the Function of an Aortic Valve?

The aortic valve typically opens three to five square centimeters during the heart's contraction (systole). Then, as the heart relaxes (diastole), this valve closes and prevents leakage of blood from the ascending aorta backward to the heart. Throughout one's lifespan, the aortic valve opens and closes an average of several billion times.

What Is Aortic Valve Sclerosis?

Aortic valve sclerosis is a disease or medical condition characterized by the thickening of the aortic valve. Aortic valve sclerosis is a degenerative disease. Diseases characterized by a slow, long-term tissue structure or functionality decline are known as degenerative diseases. The incidence of aortic valve sclerosis increases with an increase in age. Therefore, it is most often found in older individuals. Less than ten percent of individuals under sixty have aortic valve sclerosis. Twenty to forty percent of those over seventy have aortic sclerosis.

Is Aortic Valve Sclerosis the Same as Aortic Stenosis?

Although the thickening of the aortic valve characterizes both conditions, they differ. Aortic valve sclerosis is a condition wherein the aortic valve thickens but does not obstruct blood flow, unlike aortic valve stenosis, wherein the blood flow is completely blocked.

What Are the Signs and Symptoms Associated With Aortic Valve Sclerosis?

Since it is an asymptomatic disease, no signs and symptoms are associated with aortic valve sclerosis. However, a mild or soft murmur (heart sound) is occasionally heard on physical examination.

What Are the Risk Factors Associated With Aortic Valve Sclerosis?

The following risk factors are associated with aortic valve sclerosis-

Age- Aortic valve sclerosis is more common in elderly individuals.
Hypertension- It is defined as increased blood pressure, which makes an individual susceptible to heart disease. It is a severe condition that can lead to the wear and tear of blood vessels, consequently causing cardiac problems like myocardial infarctions (MI or heart attacks), aneurysms (weakening or ballooning of the blood vessels), or strokes (brain damage occurring due to disruption in the blood supply of the brain). Hypertension could either be primary or secondary.
Diabetes- A condition characterized by increased sugar levels in the blood. This happens because the body has trouble moving glucose (sugar) from the blood into the body's cells. When this happens, the cells of the body are starved of energy. Over time, high blood sugar or diabetes can damage the blood vessels of the heart and other organs, leading to several health problems.
Smoking- Smoking is a significant risk factor for heart disease. The chemicals inhaled while smoking damage the heart and blood vessels.
Kidney Disease- When kidney function is impaired, the heart works harder to circulate blood to the rest of the body, which leads to hypertension, eventually causing heart disease.
Hypercholesterolemia- A condition with high cholesterol levels in the blood. Hypercholesterolemia can limit blood flow, increasing the risk of heart attacks and stroke.

How Is Aortic Valve Sclerosis Diagnosed?

Aortic valve sclerosis is often an incidental finding seen on echocardiogram, cardiac-magnetic resonance imaging (cardiac-MRI), or cardiac-computed tomography (cardiac-CT scan) during routine heart examination. Compared to a healthy aortic valve, the sclerotic valve is thicker. The sclerotic aortic valve exhibits a more calcified and brighter appearance on the heart ultrasound scan.

What Is the Treatment for Aortic Valve Sclerosis?

Although individuals with aortic valve sclerosis are susceptible to cardiovascular complications, medical intervention is not required in most cases. However, the risks of developing complications can be reduced by paying attention to blood pressure, sugar, and cholesterol levels. The following medications can be given for the regulation of the above-mentioned factors:

Statins- For example, Fluvastatin, Rosuvastatin, Simvastatin, etc.
Angiotensin Converting Enzyme (ACE) Inhibitors- For example, Captopril, Enalapril, Lisinopril, etc.
Angiotensin Receptor Blockers (ARB)- For example, Losartan, Candesartan, etc.

What Are the Complications Associated With Aortic Valve Sclerosis?

Aortic valve sclerosis may progress to a severe form of aortic obstruction- aortic stenosis. Less than two percent of cases of aortic valve sclerosis advance each year to clinical aortic valve stenosis.

Aortic stenosis, also known as aortic valve stenosis, is a valvular heart disease characterized by the dysfunction of the aortic valve due to its calcification. The aortic valve is completely blocked and obstructs the left ventricular outflow, which eventually leads to a decrease in cardiac output. The severity of aortic stenosis ranges from mild to severe and is usually asymptomatic when it is either mild or moderate. Due to the decrease in cardiac output, aortic valve stenosis has the following cardinal signs and symptoms-

Exertional Angina- Chest pain or chest tightness is observed with increased physical activity.
Exertional Dyspnea- Shortness of breath seen with increased physical activity.
Exertional Dizziness or Syncope- Increased fainting episodes seen on exertion or increased physical activity.

Aortic stenosis is a severe medical condition and needs immediate intervention with regular monitoring. If not treated, it can make an individual susceptible to strokes and heart attacks.

What Are the Signs and Symptoms Associated With Aortic Valve Stenosis?

Usually, mild disease does not show any symptoms. Hence, symptoms suggest the presence of severe aortic valve stenosis. Severe aortic valve stenosis symptoms include -

Dyspnea (shortness of breath).
Syncope (transient loss of consciousness).
Angina (chest pain).
Dizziness
Fatigue and weakness
Arrhythmia (irregular heartbeats).
Exercise intolerance.
Lightheadedness.
Numbness or tingling sensations.

Many of these symptoms will occur during activity but may also occur during rest as the disease progresses. Physical examinations reveal the following classical signs -

Systolic Crescendo-Decrescendo Murmur- It is a cardiac sound observed near the aortic portion. It begins gently and becomes loud towards the mid-point of the heart's contraction (mid-systole), followed by a gradual decrease in the intensity of the sound.
Pulsus Parvus et Tardus- A slow and late carotid pulse due to the delay in blood flow across the narrowed aortic valve.

Heart failure is a late finding and is a bad prognostic factor. It means that the left ventricle can no longer keep up with the work required to pump blood across the narrowed valve.

Treatment for Aortic Stenosis:

The severity of the condition and symptoms determines the treatment for aortic valve stenosis. An individual having mild aortic valve symptoms may only require routine examinations by a healthcare professional. To treat the symptoms of valve disease and to lower the risk of consequences, would suggest healthy lifestyle modifications and medications (if necessary).

However, surgical intervention is required in cases of severe aortic valve stenosis. The surgical options include-

Balloon valvuloplasty.
Open-heart aortic valve replacement surgery.
Transcatheter aortic valve replacement (TAVR).
Aortic valve repair.

Conclusion

Aortic valve sclerosis is a valvular heart disease in which the aortic valve does not open entirely during each heartbeat. Aortic sclerosis elevates the risk of both heart attack and stroke. Managing common cardiac risk factors, such as blood pressure, cholesterol, smoking, and obesity can help minimize the chances of developing complications.

Frequently Asked Questions

1. How Common Is Aortic Valve Sclerosis?

Aortic valve sclerosis, a condition marked by the thickening of the aortic valve, frequently affects older adults. Its occurrence rises with age, particularly in individuals with a medical history encompassing hypertension, elevated cholesterol levels, or diabetes. This condition is notably more common in those aged 65 and above. While it may remain asymptomatic in many cases, it should not be underestimated, for it can significantly increase the risk of developing cardiovascular diseases.

2. What Are the Treatment Options for Aortic Valve Sclerosis?

The treatment options for aortic valve stenosis encompass several approaches. In the early stages, careful monitoring of the disease is crucial, along with maintaining overall health, including monitoring blood sugar levels and cholesterol levels. Lifestyle adjustments, such as achieving and sustaining a healthy weight and abstaining from tobacco use, play a pivotal role in managing the condition. Medical interventions also come into play, with medications like statins, Angiotensin-Converting Enzyme (ACE) Inhibitors, and Angiotensin Receptor Blockers (ARB) being common strategies. Beyond these medical avenues, surgical procedures offer further options. These include aortic valve replacement, a more traditional surgical approach, and Transcatheter Aortic Valve Replacement (TAVR), a less invasive procedure involving the replacement of the valve through a catheter.

3. Is Aortic Valve Disease Treatable?

Aortic valve diseases, like aortic stenosis, can be managed effectively but cannot be fully restored to their healthy state. The primary treatment approaches involve medical management to regulate blood sugar, blood pressure, and cholesterol levels. Surgical treatment may also be necessary, entailing valve replacement, where the damaged valve is replaced with either a mechanical or biological alternative.

4. Are Non-surgical Methods Available for Aortic Valve Repair?

Aortic valve repair typically involves surgical procedures, but there are less invasive alternatives to traditional open-heart surgery. Among these options, Transcatheter Aortic Valve Replacement (TAVR) stands out, where a catheter is introduced through an artery to replace the valve. Another method is Balloon Valvuloplasty, which entails inflating a balloon to open the artery temporarily. However, it's worth noting that this procedure may provide only short-term relief.

5. Are There Natural Approaches to Managing Aortic Valve Issues?

Natural methods can help address issues related to maintaining bodily well-being but cannot mend damaged tissues. These approaches encompass adopting a nourishing diet, moderating the consumption of sugars, salt, and saturated fats, incorporating omega-3 fatty acid-rich foods, engaging in regular physical activity, and practicing stress management techniques such as meditation and deep breathing exercises. Moreover, they involve maintaining optimal blood pressure, a healthy weight, minimizing smoking and alcohol consumption, and limiting caffeine intake.

6. What Is the Safety Record of Aortic Valve Surgery?

Similar to any medical procedure, aortic valve surgery does entail certain risks, but it is typically considered safe with a high success rate. The safety of this procedure hinges on various factors, including an evaluation of the patient's overall health and an assessment of the specific risks associated with the surgery. This comprehensive evaluation plays a pivotal role in determining the suitability of the surgery and choosing the most appropriate approach. Notably, minimally invasive surgery results in a swifter recovery period. Nevertheless, the quality of post-operative care and the effectiveness of rehabilitation are paramount factors in ensuring the patient's recovery and overall safety.

7. What Is the Life Expectancy for Individuals With Aortic Valve Disease?

The life expectancy of individuals grappling with aortic valve disease hinges upon a multitude of factors, including the disease's severity and the accompanying symptoms, such as chest pain, breathing difficulties, and fatigue. In this medical condition, early diagnosis and the application of suitable treatment modalities can substantially enhance long-term prognoses. It's noteworthy that in younger patients, the road to recovery may prove swifter when juxtaposed with older individuals. Additionally, the presence of underlying medical conditions can exert a notable influence on the ultimate surgical outcome.

8. Is Aortic Sclerosis a Condition That Can Be Completely Resolved?

Aortic sclerosis, while not entirely curable, can be effectively managed to enhance an individual's quality of life and minimize the complications linked to it. Early-stage management primarily involves adopting a healthy lifestyle and actively controlling risk factors such as blood pressure, diabetes, and cholesterol levels. In instances of severe aortic sclerosis, the management approach may necessitate surgical interventions, such as valve replacement through minimally invasive techniques or open-heart surgery.

9. Can Aortic Sclerosis Be Reversed?

Aortic sclerosis is, unfortunately, not a condition that can be reversed. This ailment involves the thickening of the aortic valve, and it's essentially a degenerative process that cannot be undone. Nevertheless, there is room for hope as the progression of aortic sclerosis can be mitigated and effectively managed through lifestyle adjustments, the judicious use of medications, and, in severe cases, the consideration of surgical intervention as a viable option.

10. How Serious Is Aortic Valve Sclerosis as a Medical Condition?

Indeed, aortic valve sclerosis is a matter of grave concern and should never be disregarded. This condition entails the gradual thickening and stiffening of the aortic valve, potentially leading to a compromise of blood flow. Its progressive nature further exacerbates the issue, as it gradually narrows the valve and restricts the passage of blood. Over time, it can give rise to potentially severe complications like heart failure and stroke. It's imperative to note that the presence of other concurrent heart conditions can significantly accelerate the pace of its progression.

11. Can Individuals With Aortic Sclerosis Expect a Long Life?

Life expectancy is a multifaceted matter, subject to numerous variables, which encompass the degree of aortic sclerosis and the concurrent presence of other medical conditions. Aortic sclerosis, in its milder form, manifests as a thickening and stiffening of the aortic valve within the heart. Many individuals who grapple with this condition can continue to lead normal and healthy lives, although this often becomes age-dependent. The prospects for an extended life span can be substantially enhanced through timely detection, consistent monitoring, and the implementation of lifestyle modifications.

12. Are There Specific Foods That Should Be Avoided With Aortic Sclerosis?

Certain dietary choices warrant careful consideration. To foster a heart-healthy diet, it's advisable to steer clear of specific foods. Start by exercising caution with items rich in saturated and trans fats while also keeping a watchful eye on salt intake. Processed foods should generally be avoided, making room for the inclusion of healthier fat sources like avocados and nuts. Upping your fiber intake is a prudent move, as is curbing excessive sugar consumption. Make sure to incorporate Omega-3 Fatty Acids into your diet while simultaneously being mindful of your alcohol and smoking habits. Lastly, be vigilant about your caffeine intake.

13. Can Aortic Valve Sclerosis Occur Without Stenosis?

Indeed, aortic valve sclerosis can manifest independently of aortic stenosis, distinguishing itself as a distinct cardiac concern. Aortic sclerosis pertains to the thickening of the aortic valve, which leads to a modest narrowing of the blood vessels. It's a milder iteration of aortic valve disease. In stark contrast, aortic stenosis assumes a more severe form, characterized by substantial constriction of the blood vessels and a consequential reduction in blood flow. This diminished flow can pave the way for the onset of additional cardiovascular complications, which may necessitate surgical intervention for valve repair.

Sources

Dr. Muhammad Zohaib Siddiq

Cardiology

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