Medicaltalks over 3 years ago

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This is a calcified aortic valve!

Senile calcific aortic valve is the most common cause of aortic stenosis in patients who are older than 70 years old. The disease is characterized by progressive fibro-calcific remodelling and thickening of the aortic valve leaflets that evolve over years to cause severe obstruction to cardiac outflow. In simpler terms, as people age, the aortic valve can accumulate calcium, narrowing the aortal orifice and causing stenosis. The classic triad of symptoms caused by aortic stenosis is angina pectoris, dysnpoea, and syncope, however any left-predominant clinical features of heart failure may be present. This degenerative calcification shares many similarities to the process of atherosclerosis, and indeed many of the risk factors are the same, such as high LDL, diabetes mellitus, smoking, hypertension, chronic kidney disease, and the metabolic syndrome. The end-product of this atherosclerotic-like process is thickening of the valve leaflets (initially just 'aortic sclerosis') due to activation of inflammatory cascades, endothelial dysfunction, and valvular lipid accumulation. Ultimately, the valvular myofibroblasts differentiate into osteoblasts resulting in calcium deposition on the valve ('calcific aortic stenosis'). This process progressively causes a reduction in aortic valve area, resulting in progressive stenosis and eventually left ventricular outflow tract obstruction. The diseased valve is shown above and replacement with a metal or bioprosthetic valve was the way to treat.