Q. What is Aortic stenosis?
Left Ventricular outflow tract obstruction can occur due to various aortic valvular, subvalvular and supra valvular lesions.
Valvular Aortic Stenosis
Etiology
Table: Etiology of Aortic Stenosis
Congenital Unicuspid
Bicuspid
Tricuspid valve with fused commissures
Acquired Rheumatic
Degenerated Tricuspid valve
Degenerated bicuspid valve
Unusual acquired Hypercholesterolemia
Obstructive vegetation
Obstructive tumor
Rheumatic arthritis
Alkaptaneurea
Rheumatic aortic stenosis is often seen in young and middle aged individuals and is almost always associated with rheumatic involvement of mitral valve; Fibrocalcific degenerative changes of aortic valve is another important cause of aortic stenosis often seen in the elderly. Such changes occur more rapidly if the underlying valve is bicuspid or if atherosclerotic risk factors are present. Hypercholesterolemia typically hastens the degenerative changes of aortic valve and homozygous patients may present with aortic stenosis in younger age. Similarly hypertension, smoking and male sex also predispose to aortic valve degeneration leading to aortic stenosis.