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What Predisposes Someone To Aortic Stenosis
Aortic stenosis: Aortic stenosis is most commonly caused by age-related progressive calcification of a normal (three-leafed) aortic valve (>50% of cases). Other causes include calcification of a congenital bicuspid aortic valve (30-40% of cases) and acute rheumatic fever (less than 10% of cases). Diabetes, hypertension and hyperlipidemia may speed up the age-related calcification and degeneration of aortic valves. ...Read moreSee 2 more doctor answers
Vague question: You need t know the gradient across the stenosis. High gradients require valve replacement, as the left ventricle will begin to enlarge (hypertrophy) which can eventually lead to heart failure. Echocardiography and/or left ventricular angiography performed by an interventional cardiologist can define the gradient, then you both can decide on best treatment options. ...Read moreSee 1 more doctor answer
Depends: It is not just the presence of aortic stenosis, but the arrival of symptoms that determine whether the condition needs to be treated aggressively. With the development of chest pain, shortness of breath, and syncope, or fainting, the need for surgery increases. Otherwise, medical therapy may be all that is necessary for a long life. ...Read more
Fixed cardiac output: With aorttic stenosis the amount of blood pumped by the heart is fixed below a specific threshold as it cannot increase the output even with increased demand as with exercise etc. Consequently, the heart , the brain or any other organ will not get the increased blood supply it needs and therefore sudden death from irregular heart beats, myocardial infarction or syncope and brain ischemia can kill. ...Read more
Depends on symptoms: Patients with uncorrected aortic stenosis have a poor survival: half of the patients that develop angina (chest pain) will die within 5 years, half of the patients that develop syncope (passing out) will die within 3 years, and half of the patients that develop heart failure will die within 2 years. Aortic valve replacement can pretty much normalize the life span and improve symptoms markedly. ...Read more
Post operatively: People are reluctant to give pre op patients with critical aortic stenosis inotropes. They stimulate the heart, but in the case of dobutamine and milrinone (most common phosphodiesterase inhibitor) they also drop the aortic pressure past the valve, and that can be very bad. Post op, PDE's can be preferable to other inotropes because sympathomimetics worsen the stiffness of the thick LV. ...Read more
SAVR AND TAVR: Traditionally, surgical aortic valve replacement was the best method for treating significant aortic stenosis. Some patients, unfortunately, were too ill for the procedure. Transcatheter aortic valve replacement (tavr) has proven an excellent alternative for these patients. Talk to your thoracic surgeon and cardiologist to see if you are eligible. ...Read moreSee 2 more doctor answers
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