We did an article on how serious heart conditions go undetected in children often assumed as things associated with growing up or lack of proper nutrition (Read: Parents alert! Do not ignore these symptoms of heart diseases in your child). This time we bring to you another heart disorder, in adults, which often gets neglected as a problem that comes with age.“If you don’t feel energetic, get tired easily, dread taking stairs due to breathlessness and have anytime in past felt your chest tightening, then, your heart might be struggling with Aortic stenosis.” (wiki)
Aortic stenosis, in simple terms, is narrowing of heart valve which makes heart work extra to pump blood up. The heart valve stiffens and fails to open up fully. As a result, the heart exerts more, and with time, heart muscles start thickening. This reduces amount of blood collected in ventricle (heart chamber) causing breathlessness or even fainting. Aortic stenosis is the most common valvular disease with frequency of occurrence 2-7% of population over 65 years of age. These heart issues often go unnoticed and when you scroll down to the symptoms section, you’ll realize why.
What causes this heart condition?
The narrowing and stiffening of blood vessels and valves has a lot to blame to unhealthy diet and lifestyle. The other causes  can be summarized as:
- Internal calcification: This refers to deposition of calcium on the inside of valve. This can be a result both of unhealthy lifestyle and ageing. With progression of age, calcium build up increases leading to hardening. The symptoms due to this reason, might not show up until the age of 65. That’s why, after your 50th birthday, you must make a permanent schedule of getting heart checkup done annually.
- Congenital: When its a birth defect, the signs begin to show up early like when you are 5, but go unnoticed. They later bother, if you are introduced to soccer, basket ball or any such physically tiring sport. If even after weeks of running, you don’t feel your stamina boosted up, you might wanna see a cardiologist for potential heart risk.
- Rheumatic fever or Endocarditis: These are rare cases of bacterial or even fungal infection (inflammation) in heart damaging the valve. These both are, dangerous and life threatening and often, surgery for replacement is the only option.
What are the symptoms of Aortic stenosis?
The symptoms, in most cases, begin to show up when its too late to be treated by change of lifestyle. The valve by then, is reduced to quarter of its original cross section and hence, allows very little blood flow. The most common symptoms, however, are:
- Angina or chest pain: This is a heavy feeling similar to chest tightening. The pain is usually in center contrary to common belief of heart being on left side of the body. The pain, though short term, is intense and usually confused with acidity or gas by onlookers. A little myth busting here: Pain due to acidity is felt on left and angina in center. So, if you feel it was not something characteristic of acidity, rush to a cardiologist.
- Shortness of breath: Often experienced after not being able to walk even small distances without losing breath or opting for elevators instead of stairs due to inability to breath properly after a few steps. People who have never exercised in life and take up jogging or any other cardio in middle age, might complain shortness of breath even weeks after regular practice.
- Palpitations or irregular heart beat: This is a funny feeling often described as ‘feeling of spotting your crush during teenage‘. Racy heart, pounding against chest wall and uneven heart beat are some of the characteristics of palpitations. Now, you don’t have teenage crushes when you hit 60, do you?!
- Dizziness or fainting without any explainable cause
Role of exercise in Aortic stenosis
Exercise plays a crucial role in early detection of this heart condition. As I already mentioned, if you have never taken up any form of exercise and resolve to improve your lifestyle later in your 50s, its a great step, I must say. Initially, you might feel a little out of breath, quite understandably because do not possess the stamina, but gradually it builds up.
If, however, even after 2 weeks, you still feel shortness of breath, you might have some kind of cardio or respiratory issues. Make sure you do not ignore any such signs as delay in treatment could lead to sudden heart failure.
Also, exercising regularly strengthens your heart muscles and makes you aware of cardiac or any such problems earlier enough to be treated with ease.
I think I have the symptoms. What should I do?
Without delay, book appointment with a good cardiologist and discuss your case with him. He’ll examine you physically first, but to accurately listen to your heart beats, he’ll suggest you an Echocardiogram. This is different from regular ECG (electrocardiogram) people get. With echocardiogram, he’ll check for presence of any heart murmurs (mixed, unclear heart sounds in addition to regualur lubb-dub) which are a characteristic of aortic stenosis. 
Its great if he clears you of any such things. But, if you are diagnosed with stenosis, depending upon the progression of condition and your age, you might have to undergo Valve replacement surgery or, a Balloon Valvuloplasty. 
The former is a open heart surgery and may hold risks if you are too old. In such cases, balloon valvuloplasty is your rescue route, where a balloon is inflated at the site of calcification to create sufficient space for blood flow. The balloon of course is deflated and removed later.
Well, I don’t think I have any such issues. Any advice?
If you are hale and hearty, congratulations!!
Still making some healthy changes in your lifestyle to further avert the condition is a wise step.
- Improve your eating habits and lifestyle by restricting the amount of alcohol, unhealthy fats, meat, smoking and other similar things that put excessive pressure on heart.
- Engage in a little exercise everyday to further strengthen your heart, enhance immunity and, keep resistance levels high.
- If possible, opt for Mediterranean style of eating, which is known to fill you with essential nutrients and fibers while reducing the risks of obesity, diabetes, cancer, heart problems, Alzhiemer’s and Parkinson’s diseases. (For further tips, read: Mediterranean diet for a healthy heart)
Related interesting reads
References  Olszowska M. Pathogenesis and pathophysiology of aortic valve stenosis in adults. Pol Arch Med Wewn. 2011 Nov;121(11):409-13. Review. English, Polish. PubMed PMID: 22129836.  Manning WJ. Asymptomatic aortic stenosis in the elderly: a clinical review. JAMA. 2013 Oct 9;310(14):1490-7. doi: 10.1001/jama.2013.279194. Review. PubMed PMID: 24104373.  Spaccarotella C, Mongiardo A, Indolfi C. Pathophysiology of aortic stenosis and approach to treatment with percutaneous valve implantation. Circ J. 2011;75(1):11-19. Review. PubMed PMID: 21178291.