AORTIC STENOSIS

narrowing of the passage between the left lower chamber (ventricle) of the heart and the aorta, the principal artery of the systemic circulation. The defect is most often in the valve at the mouth of the aorta but may be just above or below the valve (supravalvular and subvalvular aortic stenosis, respectively). Aortic stenosis in a person younger than 20 years of age is usually congenital in origin. If it appears during middle age, it is most often the result of rheumatic heart disease. Aortic stenosis in elderly persons may be the result of degeneration of the valve with age. Most patients are male. Aortic stenosis causes characteristic heart sounds, audible through a stethoscope. Affected persons may faint after exertion or may experience the chest pain known as angina pectoris. The stenosis may bring about congestive heart failurethe effects of the heart's inability to function adequately as a pump. Medical treatment is directed toward the angina pectoris and heart failure and toward prevention of bacterial invasion of the heart lining (endocarditis). Surgical treatment consists in repairing the aortic valve or replacing it with a synthetic substitute or a transplant.