It is not uncommon to hear older people say they are feeling tired. Often, they attribute this to aging and begin cutting down on their daily activities. But these seemingly normal complaints could be a sign of a serious illness, such as heart disease.
Something similar happened with 75-year-old Deepak (name changed), who ignored his wife’s words. breathlessness And fatigue came to be seen as a symptom of old age. When he suddenly fainted during a family vacation, doctors discovered he was suffering from senile dementia. aortic stenosis or narrowing of the valves in his heart. Timely treatment with transcatheter aortic valve implantation (Tavi) helped his heart pump properly.
Let’s understand aortic stenosis
Think of the heart as a busy engine that keeps your body running. Inside this engine, there are four compartments, or ‘rooms’, that clean and oxygenate your blood before sending it to the rest of your body with the help of the lungs. These rooms are connected by valves, which act like doors that open and close to control the flow of blood.
One of these valves, called the aortic valve, is especially important because it lets oxygen-rich blood leave the heart and flow to the rest of your body. But sometimes, this valve can become too narrow or blocked, making it harder for the heart to pump blood. This condition is called aortic stenosis. This puts pressure on the heart and can cause damage over time.
Why is this important?
Aortic stenosis is more common than you might think. It is estimated that 9.4 to 12.6 million people worldwide suffer from the disease. However, its prevalence may be much higher because in many cases the condition is asymptomatic and goes undiagnosed. If left untreated, patients with severe aortic stenosis may suffer from heart failure and die within two to five years. It is important to be aware of the disease and its symptoms so that prompt treatment can be received.
Things to keep in mind
Some of the underlying causes of aortic stenosis are:
* Age-related wear and tear
* congenital Heart disease or other long-term conditions (such as diabetes, high blood pressure)
* Childhood infections (such as chronic strep throat or scarlet fever – rheumatic heart disease)
Common symptoms include tiredness, dizziness, fainting, breathing problems, swelling in the legs or ankles, fatigue, palpitations (fast heartbeat) and chest pain (during exertion). These symptoms can easily be overlooked or, in the case of the elderly, attributed to age, leading to delayed diagnosis and poorer outcomes.
Doctors diagnose this condition by listening to abnormal heart sounds or through imaging tests such as trans-thoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE).
Treatment Options
In severe cases where the heart valve is too damaged, the only solution is to replace it. Depending on the patient’s age, overall health and the severity of the aortic stenosis, the choice is usually made between surgical aortic valve replacement (SAVR) or a less invasive procedure called transcatheter aortic valve implantation/replacement (TAVR/TAVI). Shared decision-making between physicians and patients ensures that treatment is tailored to the patient’s values, preferences and lifestyle. Below are some of the key aspects to consider.
* SAVR is traditional open-heart surgery in which the surgeon makes an incision in the middle of the chest to access the heart and place the valve. This type of surgery is suitable for younger patients and those with no complications.
* TAVI is a less invasive option often recommended for older patients, those with other health problems that make surgery risky, or those who are very frail. In this procedure, the doctor inserts a catheter (thin tube) through a blood vessel in the upper thigh to reach the heart. TAVI usually results in a faster recovery, shorter hospital stay, and fewer risks. Recent technological improvements in TAVI include the development of self-expanding valves, which are especially useful for patients with very small or narrow anatomy. These valves adjust themselves to the patient’s heart and tend to last longer.
Aortic stenosis is a serious and potentially life threatening condition. Ignoring the symptoms can lead to a heart attack or sudden death. The most important thing is to recognise the symptoms early and seek medical help immediately. If you or a family member has trouble breathing or fainting, see a doctor immediately as this could be a sign of a serious problem. With early detection and new treatment options like TAVI, conditions like aortic stenosis can be treated effectively, allowing patients to lead a healthy life.
(Author: Dr. S. Nagendra Boopathy, Senior Consultant, Interventional Cardiology, Sri Ramachandra Hospital, Chennai)
Something similar happened with 75-year-old Deepak (name changed), who ignored his wife’s words. breathlessness And fatigue came to be seen as a symptom of old age. When he suddenly fainted during a family vacation, doctors discovered he was suffering from senile dementia. aortic stenosis or narrowing of the valves in his heart. Timely treatment with transcatheter aortic valve implantation (Tavi) helped his heart pump properly.
Let’s understand aortic stenosis
Think of the heart as a busy engine that keeps your body running. Inside this engine, there are four compartments, or ‘rooms’, that clean and oxygenate your blood before sending it to the rest of your body with the help of the lungs. These rooms are connected by valves, which act like doors that open and close to control the flow of blood.
One of these valves, called the aortic valve, is especially important because it lets oxygen-rich blood leave the heart and flow to the rest of your body. But sometimes, this valve can become too narrow or blocked, making it harder for the heart to pump blood. This condition is called aortic stenosis. This puts pressure on the heart and can cause damage over time.
Why is this important?
Aortic stenosis is more common than you might think. It is estimated that 9.4 to 12.6 million people worldwide suffer from the disease. However, its prevalence may be much higher because in many cases the condition is asymptomatic and goes undiagnosed. If left untreated, patients with severe aortic stenosis may suffer from heart failure and die within two to five years. It is important to be aware of the disease and its symptoms so that prompt treatment can be received.
Things to keep in mind
Some of the underlying causes of aortic stenosis are:
* Age-related wear and tear
* congenital Heart disease or other long-term conditions (such as diabetes, high blood pressure)
* Childhood infections (such as chronic strep throat or scarlet fever – rheumatic heart disease)
Common symptoms include tiredness, dizziness, fainting, breathing problems, swelling in the legs or ankles, fatigue, palpitations (fast heartbeat) and chest pain (during exertion). These symptoms can easily be overlooked or, in the case of the elderly, attributed to age, leading to delayed diagnosis and poorer outcomes.
Doctors diagnose this condition by listening to abnormal heart sounds or through imaging tests such as trans-thoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE).
Treatment Options
In severe cases where the heart valve is too damaged, the only solution is to replace it. Depending on the patient’s age, overall health and the severity of the aortic stenosis, the choice is usually made between surgical aortic valve replacement (SAVR) or a less invasive procedure called transcatheter aortic valve implantation/replacement (TAVR/TAVI). Shared decision-making between physicians and patients ensures that treatment is tailored to the patient’s values, preferences and lifestyle. Below are some of the key aspects to consider.
* SAVR is traditional open-heart surgery in which the surgeon makes an incision in the middle of the chest to access the heart and place the valve. This type of surgery is suitable for younger patients and those with no complications.
* TAVI is a less invasive option often recommended for older patients, those with other health problems that make surgery risky, or those who are very frail. In this procedure, the doctor inserts a catheter (thin tube) through a blood vessel in the upper thigh to reach the heart. TAVI usually results in a faster recovery, shorter hospital stay, and fewer risks. Recent technological improvements in TAVI include the development of self-expanding valves, which are especially useful for patients with very small or narrow anatomy. These valves adjust themselves to the patient’s heart and tend to last longer.
Aortic stenosis is a serious and potentially life threatening condition. Ignoring the symptoms can lead to a heart attack or sudden death. The most important thing is to recognise the symptoms early and seek medical help immediately. If you or a family member has trouble breathing or fainting, see a doctor immediately as this could be a sign of a serious problem. With early detection and new treatment options like TAVI, conditions like aortic stenosis can be treated effectively, allowing patients to lead a healthy life.
(Author: Dr. S. Nagendra Boopathy, Senior Consultant, Interventional Cardiology, Sri Ramachandra Hospital, Chennai)
