Aortic Stenosis: Etiology and Management

The cause of aortic stenosis varies in different age groups. In infants and adolescents, the etiology of aortic stenosis is commonly congenital e.g., congenital aortic stenosis, congenital subvalvular aortic stenosis, and congenital supravalvular stenosis. In young adults and middle-age group, the cause of aortic stenosis is usually rheumatic or calcifications and fibrosis. In elderly, aortic stenosis is secondary to rheumatic disease, calcification of bicuspid valve, and senile degenerative changes. Aortic stenosis is usually asymptomatic until cardiac output is maintained. With the progression of stenosis, the pressure rises, resulting in hypertrophy of myocardium. The blood supply is usually not sufficient to hypertrophied left ventricle via coronary arteries, hence patient presents with angina, syncope, and breathlessness. The condition can progress to pulmonary edema. Thrusting apex beat is usually heard. It is usually associated with ejection systolic murmur. In asymptomatic patients, timely diagnosis ensures good prognosis; only conservative management and surveillance is required. In patients with moderate to severe symptoms, aortic valve replacement is imperative. Aortic balloon valvuloplasty may be done in cases of congenital aortic stenosis. Source: Davidson's Principles and Practice of Medicine, 23rd Edition Video courtesy: https://www.youtube.com/watch?v=xspR8LuZCks