Severe aortic stenosis is a quite common clinical condition, particularly among individuals older than 70 years. It is usually accompanied by symptoms such as chest pain, easy fatigue, dyspnea and fainting attacks. However due to the timing of clinical presentation, symptoms are often attributed to other co-morbidities or simply the age of patient.
Physical examination is sometimes misleading in guiding diagnostic thinking, since the most expected physical findings are not always present. Diagnosis is easily made with echocardiography, a simple, convenient and non-invasive diagnostic procedure. With the use of ultrasound the physician is able to accurately determine the severity of aortic valve stenosis and also evaluate the function of other valves and the contractility of the heart. This echocardiographic evaluation is of paramount importance for the final decision regarding any therapeutic intervention.
Several medications have been used in order to regress or even delay the worsening of this condition, but none was found to be successful. The only way to manage this form of valvulopathy is surgical replacement of the pathologic valve. Each patient needs to be evaluated thoroughly in order to assess the surgical risk and the expected benefit from such intervention.
In general, a patient should be referred for surgery when the severity of aortic valve stenosis is documented (aortic valve area < 1cm2) and also when symptoms are present. For patients who are considered to be at high risk for a traditional surgical operation there is now the option of a transcutaneous procedure (TAVI).
After a successful replacement of the aortic valve the patient will be able to resume back to the normal daily activities without any restrictions, and most importantly without symptoms.