Untreated Severe Aortic Stenosis is a deadly condition that may be present in 1 in 8 patients over the age of 75 years old.1

If left untreated a many as 50% of patients may not survive more than 2 years. Untreated aortic stenosis has a poorer prognosis than many cancers in the community when compared to survival rates at 5 years2

Reference- 1: Otto, C. VALVE DISEASE: Timing of aortic valve surgery. Heart. 2000;84(2):211-218. # Reference- 2: https://newheartvalve.com/au/understand-aortic-stenosis/risks-of--severe-aortic-stenosis

Aortic Stenosis

is a condition that can be characterised by calcium deposits building up on the leaflets of the Aortic valve. This can lead to stiffening and narrowing of these leaflets, narrowing the opening of the aortic valve, which may reduce the blood flow and affects the cardiac output.1

AS is classified as2:

Reference: 1 https://hopeforhearts.com.au/aortic-stenosis/ Reference: 2 https://newheartvalve.com/au/understand-aortic-stenosis/what-is-aortic-stenosis

Decreased exercise tolerance

Severe untreated Aortic Stenosis (AS) may present as a significant decline in exercise tolerance, this may mean that someone is unable to finish the housework they have started, unable to walk as far as they could 12 months ago or avoid activities that can increase symptoms of shortness of breath, chest pain and dizziness or syncope. This may often be confused with the ageing process, but is not considered a normal process of getting older.1

Many of these symptoms can be relieved with rest, potentially indicating severe Aortic Stenosis, and you should see your local doctor to discuss these symptoms.2

Reference: https://newheartvalve.com/au/understand-your-heart/heart-valve-disease Reference: https://hopeforhearts.com.au/aortic-stenosis

Signs of Severe Aortic Stenosis (AS)

  • Chest Pain

    Can be caused by severe AS due to a reduction in cardiac output when performing activities such as housework, gardening when blood is leaving the heart via a narrowed or stiff Aortic valve

  • Shortness of Breath

    May occur when performing activities around the house, shopping etc. This may be caused due to an increase in oxygen demands and the heart is unable to meet this requirement due to the decreased cardiac output caused by the diseased Aortic valve

  • Dizziness or Syncope

    This may present when performing exertional activities as mentioned above. This can be due to a decreased cardiac output, reducing oxygen to the brain causing “blackouts” or near fainting episodes

    Reference: https://hopeforhearts.com.au/symptoms
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Diagnosing Severe Aortic Stenosis (AS)

If your Doctor is concerned you may be at risk of severe AS, there are a few simple tests that may be used to confirm these suspicions:

  • Heart Auscultation- a stethoscope may be used to listen to your heart for a cardiac murmur, which may indicate abnormal blood flow through the heart and heart valves. This may present as a "murmur", which may indicate "leaky" valves in the heart. The presence of a murmur may indicate a structural heart issue that needs a referral to a Cardiologist or Cardiac surgeon for treatment.
  • Chest x-ray- can be a helpful tool to rule out any underlying lung conditions that may be causing symptoms such as shortness of breath. There are structural changes to the heart that occur caused by untreated aortic stenosis. These can lead to early signs of heart failure and an enlarged heart. A chest x-ray may help diagnose this.
  • Echocardiography- is the use of ultrasound waves to help visualise the structures within the heart, such as heart valves and measure them and assess the effectiveness of valve function. It also allows cardiologists to look if there have been other structural changes to the heart such as muscle wall thickening that can occur in untreated aortic stenosis.
Reference: https://hopeforhearts.com.au/aortic-stenosis/diagnosis/

Treatment Options for Severe Aortic Stenosis (AS)

Severe untreated aortic stenosis is a serious condition. The only way to treat the condition and resolve many of the symptoms is to replace the diseased aortic valve1. Once a patient has been diagnosed with severe AS, individualized treatment options may be discussed with a number of different doctors and allied health professional. This team will discuss all aspect of each patient and consider which treatment is the best optinon for each patient.This wil multidisciplinary team will include (but is not limited to):

  • Cardiologists
  • Cardiac Surgeons
  • Cardiac Anaesthetists
  • Geriatricians
  • Registered Nurses2

Reference: 1 https://newheartvalve.com/au/understand-your-heart/risks-of-severe-aortic-stenosis
Reference: 2 https://hopeforhearts.com.au/accredited-heart-team

Individualised treatment options may include

Balloon Valvuloplasty

Is a temporary treatment where a balloon is inflated within the diseased aortic valve and then deflated. This increases the size of the opening of the aortic valve, increasing blood flow. This may relieve symptoms temporarily, however it is widely accepted that symptoms may return.1

Surgical Aortic Valve Repair (SAVR)

This is the traditional method to replace the aortic valve. Cardiac surgeons will make an incision either in the middle of the sternum or a smaller incision in the chest wall to access the heart. The aortic valve is removed and a new tissue or mechanical valve inserted. This valve will begin to work immediately. The procedure may require a number of days in the ICU and then the ward prior to going home to complete the recovery process.2

Transcatheter Aortic Valve Implantation/Replacement (TAVI/R)

This technique uses a catheter to deliver a new tissue valve into the heart via the femoral arteries in the groin. In some cases, the catheter is introduced directly into the bottom of the heart. Once the catheter is inserted, it will be placed within the diseased aortic valve, and a balloon inflated, this pushed the old aortic valve out of the way and leaves a new tissue valve, that begins working straight away. Patients may be discharged the following day to recover at home3

Reference: 1 - https://newheartvalve.com/au/explore-treatments/about-open-heart-surgery/ Reference: 2,3 - https://hopeforhearts.com.au/treatment

Severe Aortic Stenosis Treatment

In most cases, once the diseased valve has been replaced, the symptoms of Aortic Stenosis may begin to resolve over time.

Depending on the treatment option your Multidisciplinary team recommend, patients may be able to go home 1-2 days after surgery.

Reference: https://hopeforhearts.com.au/treatment

See your local Doctor is you or one of your loved ones is concerned that they may be at risk of this condition

All content has been sourced from Australia and New Zealand’s leaders in
Aortic Stenosis treatment and patient information

For more information visit

https://newheartvalve.com/au/ and https://hopeforhearts.com.au/