The little-known heart condition becoming one of Australia’s biggest silent killers

Nov 09, 2020
Aortic stenosis is a common heart condition that affects an estimated one in eight elderly Australians. Source: Getty.

There’s a good chance you’ve all heard the heart-related terms stroke, heart attack, heart failure, coronary artery disease and blood pressure, but how many of you have heard of the heart condition aortic stenosis?

Aortic stenosis is a common heart condition that affects an estimated one in eight elderly Australians, Dr Karl Poon tells Starts at 60. However, despite its prevalence, little is known about the deadly disease, which can lead to problems like fluid in the lungs, an enlarged heart, heart failure and heart arrhythmia (an irregular heartbeat).

What is aortic stenosis?

To put it simply, aortic stenosis is a narrowing of the aortic valve opening. According to Dr Poon, the heart has four valves, explaining the aortic valve “is essentially the exit”. The job of the valves is to keep blood moving through the heart in the right direction.

Due to the narrowing, which is usually caused by a build-up of calcium (this is the most common cause of aortic stenosis in people aged 70 years and over), the heart has to work harder to push the blood out into the aorta, the artery that carries blood to the rest of the body.

“Ultimately, the heart can grow bigger, or the aorta could dilate, usually leading to cardiovascular issues if left untreated,” Dr Poon says.

Aortic stenosis can also be caused by rheumatic heart disease, a condition that can scar the aortic valve and narrow its opening, while some people are born with an aortic valve that is shaped differently, which may also cause the valve to narrow over time.

What are the symptoms of aortic stenosis?

Aortic stenosis isn’t labelled one of Australia’s biggest silent killers for no reason. Symptoms of aortic stenosis which may include shortness of breath, dizziness or tiredness, chest pain and palpitations, can be hard to spot, as they’re often put down to ageing and, therefore in many cases, aortic stenosis is simply not detected or not detected early enough. Studies show at least 40 per cent of patients with severe aortic stenosis don’t receive treatment. Not to mention, up to 50 per cent of people who develop severe aortic stenosis symptoms will die within an average of two years if they don’t receive treatment.

“This is why we want to increase awareness among [older] Australian[s], in an effort to improve detection and treatment,” Dr Poon says, adding if you’re having symptoms like this, don’t just put it down to old age, and speak to your GP.

How is aortic stenosis treated?

For patients with mild or moderate aortic stenosis, Dr Poon says monitoring and regular check-ups with your GP or cardiologist is the usual go-to. However, in the case of severe aortic stenosis you may need an operation to remove the aortic valve and replace it with an artificial one. For many years, replacing the aortic valve could only be achieved by open-heart surgery, which can be life-threatening for many elderly patients. The good news is there’s a less-invasive treatment option now available. The treatment is called Transcatheter Aortic Valve Implantation (TAVI), and unlike open-heart surgery, the surgeon makes a small cut, usually in the groin, and inserts the artificial valve into the femoral artery (a large artery in the thigh), which then travels to the heart and replaces the damaged valve, Dr Poon says, explaining, “It does not remove your old valve, it fits within the diseased valve.”

“Medical studies on the TAVI procedure show better recovery times with lower rates of heart incidents in the months after, compared to open heart surgery,” he says. “It also requires shorter hospital stay, and obviously removes the anxiety of having to go through a heavy surgical procedure. Generally, patients can get back to their normal lives and do what they love quicker.”

At the start, this procedure was only open to patients who couldn’t have open-heart surgery due to high risk, but the treatment is now available to many more Australian patients. We’d recommend speaking with your GP to see if this option is available for you.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.

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