The heart’s four small valves play a big role in circulation. They are the heart’s gatekeepers, controlling blood flow in and out. But when a condition called stenosis causes the valves to become narrow and stiff, it makes it hard for blood to pass through. That can lead to uncomfortable symptoms and serious heart damage.
Aortic stenosis, which affects the heart’s aortic valve, is one of the most common — and one of the most serious — types of heart valve disease. But it’s not the only valve that can run into trouble. “All four of the valves in the heart can be affected by stenosis,” says Pedro Villablanca Spinetto, M.D., an interventional cardiologist at Henry Ford Health.
Fortunately, treatments exist. Here’s what you should know if you or a loved one is at risk for heart valve stenosis.
What Causes Heart Valve Stenosis?
Heart valves are made up of small flaps called leaflets. The leaflets open and close to let blood move through. If the leaflets become thickened or stiff, they no longer open all the way. “When the valve is open wide, the heart can deliver blood to the rest of the body, and the organs are happy,” says Dr. Villablanca Spinetto. “When that door doesn’t open as widely as it should, the heart has to squeeze harder.”
That strains the heart over time and can lead to heart failure.
Narrowed valves are most common in older adults. “Aging is the biggest risk factor for developing stenosis,” Dr. Villablanca Spinetto says. But it can also affect younger people, especially those who are born with certain heart defects. The aortic valve normally has three leaflets, for example. But some people have only two — a change that puts them at greater risk of stenosis.
Heart Valve Stenosis Symptoms
Symptoms of stenosis can include:
- Rapid heartbeat
- Shortness of breath
- Chest pain, tightness or pressure
- Dizziness (sometimes fainting during physical activity)
- Trouble walking and sleeping
- Swelling in the legs
“Sometimes symptoms are vague, and patients just don’t feel like themselves,” Dr. Villablanca Spinetto says. “Often, it’s diagnosed when a doctor detects a heart murmur during a regular physical.”
Heart Valve And Aortic Stenosis Treatment
Some people have stenosis that remains mild for years. In that case, your doctor might monitor you over time rather than suggesting treatment right away. For others, stenosis can become severe quickly. “There’s no medication that can slow the progression,” Dr. Villablanca Spinetto says. “But if a patient has severe aortic valve stenosis, they need treatment.”
There are two main approaches for heart valve repair and replacement:
- Surgery: Surgeons sometimes perform open-heart surgery to repair or replace the faulty valve. This is the only option for people who choose a mechanical valve (made of metal and carbon) instead of one made from human or animal tissue. It can also be a good option for people who have multiple problems, such as valve disease in more than one valve or aorta damage. The aorta is the main artery that carries blood out of the heart. In those cases, a surgeon can fix all the problems during one procedure.
- Transcatheter treatments: Minimally invasive procedures called transcatheter treatments can repair or replace a damaged valve. A doctor inserts a thin tube, or catheter, into an artery via a tiny incision to reach the heart and replace the damaged valve.
TAVR And Transcatheter Procedures
One of the best examples of transcatheter treatments is transcatheter aortic valve replacement (TAVR). It began as an aortic stenosis treatment for people who weren’t healthy enough for open-heart surgery. But after studies proved it was safe and effective, heart specialists now recommend it as the first option for most people who need an aortic valve replacement.
Following the success of TAVR, researchers have gone on to develop similar transcatheter treatments for other valves as well. “We expect even more options for heart valve disease in the coming years,” Dr. Villablanca Spinetto says. And patients are reaping the benefits of this technology. “Most patients who receive transcatheter valves have a smooth outcome and go home the next day. They can resume their lives,” he adds.
Dr. Pedro Villablanca Spinetto is an interventional cardiologist who sees patients at Henry Ford Hospital and Henry Ford West Bloomfield Hospital.