Heart: aortic stenosis

i canis

Contributor(s):

Serena Brownlie

Donald Schrope

Mark Oyama

Introduction

Common congenital disease (subaortic stenosis (SAS) or more rarely, acquired (aortic valve stenosis (AVS)).
Cause: obstructive malformation of left ventricular outflow tract or aortic valve, less commonly supravalvular.
Signs: asymptomatic, exercise intolerance, syncope, sudden death; left-sided congestive heart failure (CHF).
Diagnosis: radiography, echocardigraphy, auscultation.
Treatment: symptomatic management, rarely balloon dilation, or surgery.
Prognosis: good to poor depending on severity of stenosis.
Print off the owner factsheet Congenital heart disease - aortic stenosis Congenital heart disease - aortic stenosis to give to your client.

General

SAS: developmental congenital cardiac abnormality.
AVS: degenerative and calcific disease leading to stiffness and calcification of the aortic valve leaflets.

SAS/AVS: obstruction to aortic flow can lead to a decrease in cardiac output at rest or with exercise and stress. If cardiac output is decreased at rest then clinical signs of lethargy and weakness may be evident. If cardiac output is decreased during exercise then evidence of exercise intolerance or syncope may be seen.
SAS/AVS: obstruction to aortic flow can result in left ventricular hypertrophy. If the hypertrophy is significant, the coronary blood flow may not be adequate to maintain normal perfusion to all of the muscle, especially the subendocardial regions. This could lead to hypoxia of the muscle. Hypoxia of the muscle could lead to the development of ventricular arrhythmias. If the arrhythmias are severe enough they could result in lethargy, weakness, exercise intolerance, syncope, or sudden death.
Older patients with SAS or AVS may eventually develop significant elevations in left atrial pressure and size. This could lead to the development of left-sided CHF.