Date: July 16th, 2014
Aortic Stenosis in Seniors Explained
Older Americans today are more active than previous generations, and the percentage of people age 65 and older who meet exercise recommendations continues to grow. However, for some seniors, activities such as walking up a flight of stairs or playing with grandchildren can result in dizziness, fatigue or even fainting. All of these symptoms could be harmless, but that does not mean they should be ignored. They could be stemming from a condition called aortic stenosis, a serious heart valve disease. Because these symptoms are often wrongly dismissed as “normal” consequences of aging, it’s important that a health care professional knows about all of your (or a loved one’s) potential symptoms as soon as possible.
Aortic stenosis is a heart valve disease that involves the stenosis, or narrowing, of the aortic valve. This narrowing keeps the valve from opening all the way and reduces blood flow—straining the heart. As the narrowing gets worse, the heart works harder to pump. Over time heart problems develop and can cause heart failure.
Aortic stenosis is most often seen among people over the age of 65 and affects men and women equally. The most common cause of aortic stenosis is the natural build-up of calcium on the valve over time—calcific aortic stenosis. Other risk factors include having a bicuspid valve, which is a congenital heart defect (from birth) where the aortic valve only has two leaflets, and a history of rheumatic fever.
The Warning Signs of Aortic Stenosis
Early in the disease, it is common to have no warning signs or symptoms, making it difficult to detect. Often, the first sign of aortic stenosis is an abnormal heart sound, or heart murmur, that can be detected by your health care professional. This murmur may occur long before other signs. As the disease progresses, other symptoms may occur, such as:
• Pain, tightness or discomfort in the chest
• Fainting or nearly fainting
• Shortness of breath
• Rapid or irregular heartbeat
• Inability to exercise
If you or a loved one is experiencing any of these symptoms, please let a health care professional know right away.
Left untreated, aortic stenosis can lead to chest pain, heart failure, irregular heartbeat and even death. The average life expectancy after onset of chest pain is less than three years. Once the heart begins to fail, the average life expectancy drops to just six to 24 months. Thankfully there are treatments available that can dramatically reduce mortality and increase quality of life among patients.
Valve replacement is the only way to eliminate aortic stenosis. Surgical aortic valve replacement (AVR) is an effective treatment for adults with severe and symptomatic aortic stenosis. The risks of complications and death are quite low and, while they do rise slightly with age, this alone is not a reason to avoid the surgery. Unless other serious diseases or conditions could complicate the surgery, almost all symptomatic patients are good candidates. Four out of five people who survive surgery have marked symptom improvement, and the majority retain independence after surgery.
Transcatheter aortic valve replacement (TAVR) is a new technique that is less invasive and is a good alternative to AVR for individuals at high risk for surgical complications.
The Alliance for Aging Research recognizes the importance of early detection and appropriate treatment for aortic stenosis patients. This spring, the Alliance released a “pocket film” aimed at raising awareness about the signs, symptoms and treatment options available for this condition. This short and shareable film is available on YouTube and is meant to be passed on to family members, friends and loved ones.
If you have aortic stenosis or suspect that you might, take our educational quizzes to learn more; you can print the results to share with your health care professional at your next visit. Also, check out our patient brochure with more in-depth information about the disease. The Alliance’s aortic stenosis resource page contains a podcast series with information and perspectives from a cardiologist and two aortic stenosis patients and a series of expert videos.