Aortic stenosis symptoms

Aortic Stenosis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2], Abdul-Rahman Arabi, M.D. [3], Keri Shafer, M.D. [4], Priyamvada Singh, MBBS [5], Mohammed A. Sbeih, M.D. [6]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [7]

Overview

Aortic stenosis can cause many symptoms such as dizziness, syncope, angina, and congestive heart failure. Research has speculated that some conditions may be caused an aortic stenosis, including Heyde's syndrome and Von Willebrand factor.

Symptoms

When symptomatic, aortic stenosis can cause:

• Exertional dyspnea.
• Angina pectoris.
• Syncope.
• Dizziness.

Late in the disease course, symptoms of decreased cardiac output may appear on the patients. These includes:

• Marked fatigability.
• Weakness.
• Peripheral cyanosis.
• Congestive heart failure.This carries a grave prognosis in patients with AS. Patients with CHF that is attributed to AS have a 2 year mortality rate of 50%, if the aortic valve is not replaced. CHF in the setting of AS is due to a combination of systolic dysfunction (a decrease in the ejection fraction) and diastolic dysfunction (elevated filling pressure of the LV). Symptoms of LV failure may include:

• Orthopnea.
• Paroxysmal nocturnal dyspnea.
• Pulmonary edema.

• Pulmonary hypertension that can lead to:

• Right ventricular failure.
• Systemic venous hypertension.
• Hepatomegaly.
• Atrial fibrillation.
• Tricuspid regurgitation.

Patients exhibiting multiple symptoms often experience a worsened prognosis and overall decrement in quality of life.

Associated Symptoms

In Heyde's syndrome, aortic stenosis is associated with angiodysplasia of the colon. Recent research has shown that the stenosis causes a form of von Willebrand disease by breaking down its associated coagulation factor (factor VIII-associated antigen, also called von Willebrand factor), due to increased turbulence around the stenosed valve.

References

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