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What is Aortic Stenosis?

The aortic valve is a one-way heart valve that operates as the left ventricle begins to pump blood out of the heart. It’s function is to prevent any ‘backwash’ of blood back into the ventricular chamber when it has completed it’s beating cycle. Aortic Stenosis, or aortic valve stenosis – is a serious degenerative condition where the aortic valve becomes obstructed and does not fully open. This means that with every beat the heart has to struggle against the increased pressure of having to force the blood through a restricted opening.

What causes Aortic Stenosis?

The condition occurs as the aortic valve suffers from the effects of aging and normal use that can eventually cause the valve tissue to degenerate. This condition can be made worse by the subsequent deposition of dietary calcium that can accumulate around the worn valve opening, causing a reduction in movement of the valve. Left untreated the aorta stenosis causes an increased workload on the heart that eventually causes the heart to fail.

Symptoms of Aortic Stenosis

There are a number of symptoms that result from the strain that the heart is placed under as a result of the increased pressure in pumping blood. These include :-

• Chest pain
• Breathlessness
• Dizziness
• Blackouts
• Fatigue during exercise

There may also be a type of heart murmur or arrhythmia associated with the condition, although this may not necessarily be noticed by the sufferer.

Diagnosis

Initial diagnosis may be complicated by the nature of the above symptoms, as many of them are common to other types of heart diseases. However, diagnosis is usually confirmed by an EKG, or echocardiogram, that may show a unique type of signature trace known as an ‘S4 gallop’.

The problem of correct diagnosis is exacerbated in some older sufferers, and often leads to a delay in getting treatment. This delay may result in a crisis where the risk of surgery is considered to be too great to operate.

Aortic Stenosis Treatment

Because aortic stenosis is a mechanical problem with the flow of blood through the heart valve, there are no real treatment options apart from surgery. Some common heart disease medications may provide a temporary slight relief, but are largely ineffective. In cases of mild aortic stenosis, the patient’s condition is closely monitored, although treatment is usually delayed whilst the overall heart function is effective. 

Heart valve replacement surgery is a major operation, that involves a degree of risk – approximately 4 in 100 patients will die during the operation. Surgery to replace the defective aortic valve is usually carried out in cases of severe aortic stenosis when the cardiologist judges that the heart is in imminent danger of failing, and that the risks are outweighed by the catastrophic consequences of not operating.

Post operative recovery is usually accompanied by a rapid noticeable improvement in well-being, as the cause of the blockage is removed and normal heart function returns. Statistics show that over 80 percent of aortic valve replacement patients live for a minimum of five years.

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We’ve all heard of the expression ‘he/she died of a broken heart’. But this old saying may be closer to the truth than you think. ‘Broken heart’ is a colloquial expression that can mask many reasons for severe unhappiness, including those that result from relationship breakdown, loneliness and depression.

These two interrelated conditions often go hand in hand, and if you are unfortunate to suffer from depression, you have more than double the average risk of suffering a fatal heart attack. When we are isolated from familiar contacts such as family members, friends and acquaintances from work, then we inevitably suffer from elevated blood pressure and our bodies become more prone to all types of infection and illness, including heart disease.

Modern society has more loneliness and depression

Our modern society has more loneliness and depression than any previous generation due to the relentless increase in divorce, family breakdown, and growth of single person households, plus an aging population. This leads to increased blood pressure readings – up to thirty points higher, compared to similar people who are in stable personal and family relationships and who have active social lives.

The problem is linked to raised levels of the hormone cortisol, that has a direct relationship to higher blood pressure. Raising blood pressure by this amount can move the sufferer from normal blood pressure to pre-hypertension or full hypertension. This in turn leads to a trebling of the risk of developing heart disease and stroke, and more than double the mortality rate from suffering from the conditions.

The problem is even greater in those who are more the most reclusive in their social behaviour, and in this group of people who have significantly less contact with other human beings, the effects on their health is comparable to the risk of developing heart illness from known poor lifestyle factors such as smoking and unhealthy diet.

Women may be particularly at risk from heart disease due to depression

Depression in women leads to an even greater risk of dying from heart-related complaints such as high blood pressure, high cholesterol, heart arrhythmia and diabetes, and it appears that the risk is proprtional to the severity of the depression. Unfortunately, taking anti-depressant medication does not seem to improve the situation for most women suffering from depression. There are worrying concerns among the medical profession that there could be a relationship between the anti-depressants and the increased incidence heart problems in women taking the medicine, including twice the risk of suffering from sudden cardiac death.

What can be done to reduce loneliness and depression?

Professor John Cacioppo from the University of Chicago has studied the phenomena and has recommended that a few strong relationships are of greater value than many acquaintances of lesser value. This underpins the value of personal and family relationships, above contemporary alternative forms of social contact such as those developed by casual contact or contacts developed from the Internet that may not produce physical meeting, or contact between the participants in the relationship

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We are facing the possibility of a global influenza pandemic due to an outbreak of a type of flu known as swine flu that has recently broken out in parts of Mexico, and is now rapidly spreading to all parts of the world.

The World health organisation has issued a statement that containment of the virus is now not possible, and that we should prepare for a possible global influenza pandemic. This is because the virus is capable of spreading rapidly from person to person.

This has special relevance for people with heart disease. If you have existing heart disease you should be aware that it is generally safe for you to get a flu vaccination. But It is also true that your risk of dying from contracting flu, swine flu, bird flu or any other type of influenza is higher than those of any other group of people suffering from a chronic illness.

Additionally, those suffering from heart disease are at greater risk of developing complications from all types of influenza. These complications include breathing problems and lack of bodily hydration that can cause problems for existing heart related and other illnesses, such as heart failure, asthma and diabetes, and may even trigger a myocardial infarction (heart attack).

Precautions for preventing spread of disease

The official advice from the UK government is that this highly contagious illness is spread by bodily fluids from coughing and sneezing. The following tips should therefore be followed to minimise your risk, and should you become ill with flu-like symptoms, prevent the risk of spreading the virus to others:

• Avoid contact with people with suspected infection
• Wash your hands frequently with soap and water

If you develop cold and flu-like symptoms yourself :-

• Quarantine yourself if possible, and avoid close contact with others
• Use disposable tissues, always cover your mouth and nose, and dispose of your waste carefully
• seek medical advice by telephone initially, and follow your doctors advice

Is there a specific vaccine for swine flu?

There is currently no vaccine that is specifically targetted towards the latest outbreak of swine flu, and it will take scientists an estimated 6 months to develop one. However, regular flu medication such as Tamiflu and Relenza contains anti viral components that can mitigate some of the effects of the new virus. These existing influenza drugs will help to reduce the severity of the illness, and will also reduce the risk of heart attack in heart disease sufferers.

Although prevention is always better than cure, those of us who are immunised against existing strains of influenza may be protected from the more severe effects of the virus if we are unfortunate enough to contract the new strain.

Can I get swine flu from eating pork or pig products?

Fortunately, the swine flu virus cannot be transmitted by eating any type of food, including pork or any other food products derived from pigs.

Seasonal flu already causes thousands of deaths each year

We should not forget that outbreaks of the seasonal human influenza virus already causes tens of thousands of deaths each year in the United States and the United Kingdom. This is why physicians advise that vulnerable groups of people such as younger people and older adults are vaccinated against flu. However because people with heart disease have higher rates of complications if they do catch flu, this advice is more important for people who have heart conditions.

Warnings about flu vaccination

It is generally safe and advisable for heart disease patients to be immunised against flu. However there are a few warnings that you should be aware of :-

• You should have your flu jab done with a needle, as nasal sprays contain live virus and can trigger adverse reactions
• If you’re allergic to eggs you should consult with your doctor before taking any anti-influenza medication. This is because the drug may contain traces of egg due to the production process, and your doctor will need to balance the risks of getting the vaccine against the risk of allergic reaction

This article has been updated with new information. For the latest information please visit  ‘swine flu and heart disease update April 30th 2009‘

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By Ann-Marie Waters, Associate Editor.

According to the ‘World Health Organisation’ any form of unwelcome sound is noise pollution. Until recently the damaging effects of noise pollution on one’s health was unclear but new data concludes that irritating noise leads to high levels of stress hormones such as cortisol, adrenaline, and noradrenaline that can result in hypertension – increasing the risk of stroke, heart disease, and immune deficiencies.

The biggest offenders are air and road traffic noise, and loud music, but other irritating and prolonged noise such as a barking dog or constant banging from D.I.Y fanatics next door can increase one’s stress levels and lead to a raised blood pressure.

For instance – John Stewert, who went on to set up the ‘National Noise Pressure Group’ in the United Kingdom, was seriously affected by noise pollution when a landing aircraft flight path at Heathrow Airport, London was changed – resulting in planes flying over his apartment every 90 seconds. His sleep became interrupted and he developed heart palpitations. After visiting his doctor and finding that his blood pressure was too high, and his GP suggesting that he needed to take serious and immediate action to decrease his stress levels – he sold his house and moved to a quieter area, and subsequently his blood pressure gradually returned to normal.

Additionally, a study carried out by Cornell University in New York found that employees in an open-plan office exposed to constant noise from telephones, machinery, and chitter-chatter contained higher levels of adrenaline in their urine than employees working at a quieter self-contained work station.

What Constitutes Noise Pollution?

Many experts agree that any type of noise that is causing you to feel irritated and stressed over a prolonged period is damaging to your health. The worst scenario being: you are in a position where you cannot change the offending circumstances, and feeling trapped and helpless.

Moreover – According to Deepak Prasher Professor of Audiology (University College London), some people are unaware of the changing physiological effects taking place as they become habituated to noise over time. Women who judge themselves to be particularly sensitive to noise have an 80% increased risk of cardiovascular mortality.