Symptoms of Aortic Stenosis
Symptoms of aortic stenosis are related to the degree of obstruction of the aortic valve. Mild to moderate stenosis does not give rise to any major symptoms.The physician finds it incidentally and it is presented by a systolic murmur. When the obstruction occupies almost 1/2 of the aortic valve area , symptoms of aortic stenosis become significant . The decreased outflow of blood from the left ventricle to the aorta develops stress upon the left ventricle. To compensate for the increasing repression at the aortic valve, the muscle of the left ventricle puffs up or hypertrophies to sustain the pumping and cardiac output. The hypertrophy of the muscle reduces the pliability of the heart muscle which now demands higher pressures in the left atrium and the blood vessels of the lungs to fill the left ventricle. Eventually, elevated pressure forces the left ventricle to dilate resulting in decrease in cardiac output and heart failure. Aortic stenosis is a common problem in the elderly and approximately 2% of people over the age of 65, 3% of people over age 75, and 4% percent of people over age 85 have the disorder.
Characteristic symptoms of aortic stenosis are:-
Chest pain( Angina Pectoris) - can be noticed as a first symptom in aortic stenosis. Chest pain is usually below the breast bone(sternum) induced on exertion and relieved by rest. Typical angina pain of aortic stenosis is present with normal large and medium sized coronary arteries.The hypertrophied muscles of the heart pump against high thrust pressure to push blood through the narrowed aortic valve. There is increased demand of blood by the heart muscles causing chest pain.
Symptoms of Aortic Stenosis
Breathlessness- Shortness of breath from cardiac failure is the most significant symptom of aortic stenosis. Breathlessness in aortic stenosis is associated with an elevated left ventricular pressure. In the initial stages, the shortness of breath is only on exercise but eventually it is experienced at rest too.The length of history of breathlessness from its onset to the critical stage is usually of the order of 1-2 years.
Syncope(Fainting)- Syncope in aortic stenosis is clearly related to exercise and can be due to hypotension (low blood pressure) resulting from the combination of exercise induced vasodilation (relaxing of blood vessels) and fixed cardiac output. The heart is not efficient enough to increase the output to compensate for the fall of blood pressure. Eventually, the blood supply to the brain is lowered due to aortic stenosis, causing fainting. Due to involvement of a calcified atrio-ventricular node, there is complete blockage in atrio-ventricular block causing syncope while in some patients, fainting results from tachycardia due to aortic stenosis.