Harvard Heart Letter

Chest pain could be aortic valve disease

In aortic stenosis, the leaves of the aortic valve become caked with calcium, making them thick and stiff. Because the leaves do not open and close normally, blood flow through the heart is impaired. This can lead to symptoms such as chest pain, dizziness, or breathlessness. The risk of sudden death in people with aortic stenosis increases dramatically from the time symptoms first appear. Because surgery will be required within a year or two, some surgeons recommend replacing the valve as soon as aortic stenosis is diagnosed. Other surgeons say that because operating before symptoms appear cannot improve quality of life, waiting for symptoms is more prudent. The right choice depends on what the patient considers more important: preventing sudden death at all costs, or preserving quality of life.
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