Aortic valve stenosis in adults is due to calcific changes of a normal trileaflet or congenital bicuspid valve. Rheumatic disease is uncommon and is invariably accompanied by mitral valve involvement. The classic physical findings of severe aortic stenosis such as diminished amplitude and rate of rise of the carotid upstroke may not be seen in elderly patients due to superimposed atherosclerotic vascular disease.
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Heyde syndrome in a year-old man who underwent chest radiotherapy at young age. Santos 1L. Santos 2A.
Aortic stenosis AS refers to any condition that narrows the orifice of the aortic valve. While once caused primarily by rheumatic heart disease, this etiology is now rare in developed countries where calcific disease is now the major cause. Historically referred to as calcific degeneration, it is now clear that AS in the developed world accrues from a process much akin to atherosclerosis.
A more recent article on aortic stenosis is available. Augustine, Florida. Patient information: See related handout on aortic stenosiswritten by the authors of this article.
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The major cause of valvular AS in adults is calcification and fibrosis of a previously normal tricuspid valve or a congenital bicuspid valve, with rheumatic AS being rare in the United States. Once established, the rate of progression of valvular AS is quite variable and impossible to predict for any particular patient. Symptoms of AS are generally insidious at onset, though development of any of the three cardinal symptoms of angina, syncope, or heart failure portends a poor prognosis.
To diagnose aortic valve stenosis, your doctor may review your signs and symptoms, discuss your medical history, and conduct a physical examination. Your doctor may listen to your heart with a stethoscope to determine if you have a heart murmur that may indicate an aortic valve condition. A doctor trained in heart disease cardiologist may evaluate you.
Preoperative anemia is common in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation TAVI and has been linked to a poorer outcome — including a higher 1-year mortality. The aim of this study was to investigate the impact of successful TAVI on baseline anemia. A total of patients who survived at least 1 year following TAVI were included in this study.
A recent retrospective study found that aortic stenosis patients undergoing transcatheter aortic valve implantation TAVI commonly have comorbid anemia, which is predictive of mortality or re-hospitalization in these patients. The authors sought to determine the prevalence and impact of anemia on elderly patients with severe aortic stenosis. TAVI is a commonly used treatment for patients with severe symptomatic aortic stenosis, especially in those who are not candidates for surgical aortic valve replacement.