The aortic valve is made of three flexible cup-shaped leaflets. These leaflets are forced apart when the powerful contraction of the left ventricle pushes pressurized blood through the valve into the rest of the body. When the left ventricle has emptied, the three aortic valve leaflets snap back together in complete contact with each other.

Over many years, the wear and tear of continuous aortic valve motion leads to calcification of the valve. This accumulation of calcium causes the valve to be stiff, or stenosed and, therefore, work imperfectly.

When calcification occurs as an individual ages it is referred to as 'age-related degenerative calcific changes' or 'senile aortic stenosis'.

Calcific changes that progress to aortic stenosis can develop in two other groups of people:

1. Those born with an abnormal biscuspid (rather than tricuspid) valve.

2.Those with chronic rheumatic valve disease resulting from rheumatic fever as a child.

Age-related aortic stenosis is not uncommon in people over 65 years old. Most individuals won't experience any symptoms early in the course. However, even at this early symptom-free stage a physician can detect specific signs of aortic stenosis that can be found on a physical exam.

Signs of early aortic valve stenosis:

-A systolic murmur, meaning a murmur that occurs during contraction of the ventricles.

-Reduced intensity of the second heart sound, called S2, which is the sound of pulmonic and aortic valves snapping shut.

-An additional heart sound, called S4, that results from atrial contraction into a left ventricle that has stiffened in its efforts to generate enough pressure to get blood through the aortic valve stenosis.

Symptoms of aortic stenosis begin to occur as time passes. It is important to take note of the symptoms an individual with aortic stenosis is experiencing. This importance stems from the fact that development of specific clinical symptoms correlates with the particular survival time of individuals with aortic valve stenosis if surgical correction is not undertaken.

Symptoms of aortic valve stenosis:

-shortness of breath

-chest pain, especially during exercise

-fainting during exercise, called 'exertional syncope'

-atrial fibrillation, felt as palpitations or a racing heart

-congestive heart failure

Median survival time without surgical intervention:

Angina (chest pain) 5 years

Syncope (fainting) 3 years

Congestive heart failure 2 years

Atrial fibrillation 6 months

With appropriate treatment aortic valve stenosis should not progress to the point that surgical correction is required.

Learn more about this author, Nicole Evans.
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