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Q: I am a 65 year old man and have recently been told by my doctor that I have valvular aortic stenosis. I do not have any symptoms, but I am concerned since he told me that I may have to have surgery sometime. I am writing to you since I would like to know at what point may I need surgery.
A: Valvular aortic stenosis means narrowing of the aortic valve opening so that blood cannot easily flow from the heart to the aorta (the largest artery of the body).
The main causes of this disease are calcification of the aortic valve due to a birth defect of the valve, calcium deposition and degeneration of the valve due to increasing age, and diseased valve due to previous occurrence of rheumatic fever. When this disease is present in a young individual, it is most likely due to the valve being abnormal since birth. In particular, the abnormality usually occurring in this case is that the valve has two leaflets, rather than the standard three leaflets of which it usually consists. On the other hand, the most frequent cause of this disease at a more advanced age is degeneration of the valve with subsequent calcium deposition on it.
Surgical intervention in aortic stenosis does not have to be performed until symptoms occur. The typical symptoms of aortic valve stenosis are chest pain, syncope (loss of consciousness), and heart failure. When any of these symptoms occur, surgical intervention should be promptly considered, since the life expectancy of a patient if no surgical treatment is undergone at this point is only a life expectancy of at most five, three, and two years, respectively.
Updated: 11/12/98
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