Aortic valve stenosis and coronary artery disease
It is important to recognize that problems with your heart do not occur in isolation. If you have aortic valve stenosis along with coronary artery disease, these heart conditions can actually work together to impair the function of your heart and increase the likelihood of permanent damage.
Coronary artery disease (CAD) results primarily from the buildup of hard plaque (atherosclerosis) in the arteries that supply blood to your heart muscle (coronary arteries). CAD occurs when this buildup of plaque narrows the arteries to such a degree that the heart begins to suffer from a lack of oxygen, a condition called ischemia. If CAD becomes sufficiently severe, ischemia can begin to impact the health of your heart.
Because aortic stenosis causes a buildup of pressure inside your left ventricle (pressure overload), your heart compensates by thickening (hypertrophy). Your left ventricle will begin to lose its ability to pump blood when the pressure overload begins to overwhelm the hypertrophy. The thickened heart muscle requires a large amount of oxygen to function properly. Because CAD deprives the heart muscle of the oxygen that it needs, the combination of CAD and aortic stenosis can accelerate the failure of your heart.
As your left ventricle loses its ability to pump enough oxygen-rich blood, not only will less blood be pumped to the body, but also even less blood will actually reach the heart muscle because of the narrowed coronary arteries.
When your heart is deprived of oxygen-rich blood, you may have chest pain (angina), a common symptom of both CAD and aortic stenosis, which can be more severe when both conditions are present.
Many people with aortic stenosis have chest pain (angina) but do not have CAD. They may have pain because of an increased need for oxygen by the enlarged heart muscle. But people who are older than 35 should have tests to rule out CAD before having surgery to replace the aortic valve.
How does having a heart attack affect someone who has aortic stenosis?
If you have CAD, damage to the hard plaque in one of your coronary arteries can cause a blood clot to form that can block the flow of blood through the artery. This blockage can starve your heart muscle of oxygen and cause permanent damage, commonly called a heart attack.
If that damage occurs in the muscle of your left ventricle, it can significantly impair your ventricle's ability to compensate for aortic stenosis and can speed the onset of heart failure and permanent damage. If someone who has severe aortic stenosis experiences a heart attack that causes significant damage to the heart muscle, valve replacement surgery may not completely restore the heart's function. Damage to the muscle from the heart attack also can increase the risk of valve surgery.
| Author: | Robin Parks, MS | Last Updated: November 14, 2007 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine George Philippides, MD - Cardiology | |
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