Posts Tagged ‘bicuspid aortic valve and fluid retention in legs’
Article by peterhutch
Aortic stenosis is abnormal narrowing of the aortic valve. A number of conditions cause disease resulting in narrowing of the aortic valve. When the degree of narrowing becomes significant enough to impede the flow of blood from the left ventricle to the arteries, heart problems develop. Blood circulates through the arteries to provide oxygen and other nutrients to the body, and then returns with carbon dioxide waste through the veins to the right atrium; when the ventricles relax, blood from the right atrium passes through the tricuspid valve into the right ventricle.
While aortic stenosis associated with bicuspid aortic valves is, strictly speaking, a form of congenital aortic stenosis, it is generally classified with the degenerative aortic stenoses. Included in the congenital category are various malformations of the aortic valve itself, as well as obstructive membranes or muscular growths that form above or below the actual aortic valve. These congenital lesions appear in much younger people than the non-congenital aortic stenoses (usually in children, or occasionally in young adults), and these young patients are more prone to sudden death than older patients with aortic stenosis.
Causes of Aortic Stenosis
The three major causes of aortic stenosis are calcific degeneration or deposits of calcium on the valve (primarily affects the elderly), congenital abnormality with only two instead of three cusps, and rheumatic fever. Even in the case of a congenital defect, symptoms are most likely to occur only in adulthood.
As the aortic valve becomes more narrow, the pressure increases inside the left heart ventricle. This causes the left heart ventricle to become thicker, which decreases blood flow and can lead to chest pain. As the pressure continues to increase, blood may back up into the lungs, and you may feel short of breath. Severe forms of aortic stenosis prevent enough blood from reaching the brain and rest of the body. Lightheadedness and fainting can result.
Blood returning to your heart enters the right upper chamber (right atrium). From there, blood empties into the right ventricle underneath. The right ventricle pumps blood into your lungs, where blood is oxygenated. Blood from your lungs then returns to your heart, but this time to the left side ï¿½” to the left upper chamber (left atrium). Blood then flows into the left ventricle underneath ï¿½” your heart’s main pump. With each heartbeat, the left ventricle forces blood through the aortic valve into the aorta, your body’s largest artery.
Aortic stenosis may be present from birth (congenital), or it may develop later in life (acquired). It is caused by many disorders. One common cause is rheumatic fever, a complication of untreated strep throat. Calcification of the valve can also cause this condition. In this case, the condition is usually not seen until a person reaches their 70s.
Symptoms of Aortic Stenosis
Most patients with aortic stenosis develop one or more of these three classic symptoms: shortness of breath, passing out, and chest pain. Thickening of the walls of the left ventricle causes the ventricle to become stiff and unable to relax between contractions. When this happens, the pressure in the left ventricle rises and blood can “back up” into the lungs, interfering with normal absorption of oxygen from the lungs into the bloodstream.This may cause shortness of breath, which worsens as the left ventricle becomes increasingly impaired.
Heart failure may develop, causing symptoms that include tiredness, breathlessness and fluid retention in the legs, for example.
Aortic stenosis does not always cause symptoms immediately, even though the valve can be tight. When the heart begins to fail, symptoms of congestive heart failure can develop including fatigue, weakness, shortness of breath with exercise or at night, and swelling in the ankles.
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