Understanding Aortic Valve Stenosis

Aortic valve stenosis is a cardiovascular condition characterized by the narrowing of the aortic valve opening, which restricts the flow of blood from the left ventricle to the aorta. In a healthy heart, the aortic valve has an opening area greater than 3.0 cm², allowing smooth blood circulation throughout the body.

Causes of Aortic Stenosis

One of the most common causes of this condition is rheumatic fever, which leads to inflammation and eventual fusion of the valve's leaflets. Over time, this results in fibrosis, stiffness, calcification, and structural deformities of the valve. In younger individuals, congenital bicuspid aortic valve disease is a primary contributor to stenosis. However, in older adults, degenerative calcification—where calcium deposits build up on the valve—is the most prevalent cause of isolated aortic stenosis.

How the Heart Adapts to Valve Narrowing

When the aortic valve area is reduced by approximately 50%, the heart compensates through a process known as concentric left ventricular hypertrophy. This thickening of the heart muscle allows the left ventricle to generate higher pressures during contraction, helping to maintain normal wall stress and cardiac output during systole.

Progression to Heart Failure

As the condition worsens and the valve area drops below 1.0 cm², the left ventricle must work significantly harder to pump blood through the narrowed opening. This increased workload leads to elevated left ventricular pressure and, eventually, heightened wall stress. Over time, this strain causes myocardial ischemia, tissue scarring, and progressive heart failure, significantly increasing the risk of serious complications such as arrhythmias, syncope, and sudden cardiac death.

Importance of Early Detection

Recognizing the signs of aortic stenosis early—such as chest pain, shortness of breath, or fatigue—can be crucial for timely medical intervention. Regular cardiac evaluations, especially for those with known risk factors, can help detect the condition before it progresses to advanced stages.