Aortic valve stenosis (AS) is a disease of the aortic valve in which the opening of the valve is narrowed. When the opening of the aortic valve becomes narrowed or constricted (stenotic), the blood can not be pumped adequately and the pressure in the left ventricle increases. Over time, the LV compensates by thickening its walls in order to maintain adequate pumping pressure. In later stages, the left ventricle dilates, the wall thins, and the systolic function deteriorates.
Aortic stenosis is most commonly caused by age-related progressive calcification of the normal tricuspid aortic valve (>50% of cases). Other causes include calcification of a congenital bicuspid aortic valve (30-40% of cases) and acute rheumatic fever (less than 10% of cases).
Normal valves have three leafs (tricuspid), but some valves have two leafs (bicuspid). Typically, aortic stenosis due to calcification of a bicuspid valve appears earlier, in the 40s and 50s, while aortic stenosis due to calcification of a normal valve appears later, in the 70s and 80s. Hypertension, diabetes mellitus, hyperlipoproteinemia and uremia may speed up the process.
Approximately 2% of people over the age of 65, 3% of people over age 75, and 4% percent of people over age 85 have aortic valve stenosis. The prevalence is increasing with the aging population in North America and Europe.
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