D. Aortic Valve Stenosis

Aortic stenosis is characterized by obstruction of the left ventricular outflow tract or Narrowing of the aortic valve opening that wiil increase vascular resistance for pumping blood from the left ventricle to the aorta. The left ventricle hypertrophies and weakens, leading to left-sided heart failure.



Causes of Valvular Aortic Stenosis

Aortic stenosis typically progresses over a period of years. As the valve cusps become less mobile, the valve orifice decreases in size, resulting in an increasingly higher left ventricular systolic pressure necessary to pump blood across the stenosed valve. It will increase left ventricular afterload results first in compensatory concentric left ventricular hypertrophy.

Rheumatic fever causes inflammation of the cusps that leads to scarring; usually accompanied by mitral stenosis and leakage.

Birth defect: valve with two cusps instead of usual three; valve with abnormal funnel shape, calcium accumulates causing the valve to become stiff and narrow.

Atherosclerosis: lipids can increase calcium accumulation of the heart valves.





Signs and Symptoms of Valvular Aortic Stenosis


The people who has mild to moderate aortic valve stenosis are usually asymptomatic. As severe aortic stenosis develops, the most common initial complaint is dyspnea on exertion, followed by angina and near syncope or syncope.


If not treat properly it develop to pulmonary congestion becous leftsided heart failure occur.

Harsh, rasping, crescendo-decrescendo systolic murmur caused forced blood flow across stenotic valve.




Diagnostic Test : (see mitral stenosis)






Treatment



1. Low-sodium, low-fat low-cholesterol diet: to treats left-sided heart failure
2. Diuretics: to treat leftsided heart failure
3. Periodic noninvasive evaluation: to monitors severity of valve narrowing
4. Cardiac glycosides: to control atrial fibrillation
5. Antibiotics before medical, dental, surgical procedures: prevent endocarditis
6. Percutaneous balloon aortic valvuloplasty: to reduces degree of stenosis
7. Aortic valve replacement: to replaces diseased valve