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Aortic Stenosis with Dr Mark Hall

Introducing Dr Mark Hall, Consultant Cardiologist at Liverpool Heart and Chest Hospital. Dr Hall specialises in cardiology, heart rhythm disorders and implantable cardiac devices for the treatment of heart rhythm problems and heart failure. He is a big supporter of Heart Valve Voice is here to explain Aortic Stenosis, the disease, the symptoms and how it can be treated.

As a specialist in heart rhythm disorders I’m very interested in why the heart isn’t maintaining a healthy rhythm and not pumping blood properly. One reason for this can be diseased valves or a disorder known as Aortic Stenosis one of the leading causes of heart valve disease.

Aortic Stenosis is most common in people over the age of 50 and occurs in the aortic valve which is located on the left side of the heart. In a healthy aortic valve, the valve opens and closes to allow blood to flow through the artery and around the body. When an aortic valve is narrowed as a result of aortic stenosis, blood can no longer flow unrestricted throughout the body. This can lead to symptoms like breathlessness, dizziness when being active, feelings of tiredness and sometimes chest pains.

There are two types of stenosis. One, called valve stenosis can occur when the valve does not open enough and blood flow is obstructed and the other is a result of the valve not closing properly allowing blood to flow backwards back through the artery also called regurgitation.

Aortic stenosis can be treated with valve replacement which involves open-heart surgery where the diseased valve is replaced with and artificial or ‘mechanical’ valve. However, many patients with valve disease and aortic stenosis may not be medically fit enough for open heart surgery due to their age or other factors, and are sometimes referred for a transcatheter aortic valve replacement or a transcatheter aortic valve implantation or TAVI. Both are non-invasive and can be achieved using a thin tube (known as a catheter) which is put into the body through a small cut in either your groin or your chest. TAVI, is the insertion of a new artificial heart valve, made up of a metal frame (stent) and the outer lining (pericardium) of a cow’s heart, inside the old valve using a balloon catheter.

So we have the treatment and the knowledge, what is missing? Awareness. According to a Heart Valve Voice survey, only six percent of people in the UK over the age of 60 know about aortic stenosis. When you consider that heart valve disease affects over 1 million over 65s in the UK with that number expected to increase to 3.3 million by 2056, that six percent is just not enough.

I’ve seen the impact that lack of awareness can have in my patients. One such patient was Lydia, grandmother to Heart Valve Voice cycle team member Adrian Carrol and great-grandmother of cycle team member Jonathan Carrol. Lydia was a vibrant 92 year old who had found herself slowing down over the years, becoming breathless, experiencing occasional chest pains and in her words ‘feeling old’. She was unaware that these are the key symptoms of heart valve disease and did not feel the need to seek treatment as she thought it was all part of the ageing process. Even her GP suggested that her slowing down was a result of her advanced age. While she was finally diagnosed with aortic stenosis, by the time I was able to intervene with a valve replacement, it was too late for her and she wasn’t able to make it many days following her surgery. The unfortunate thing was that despite Lydia’s age, she was otherwise quite healthy and independent and had more years left in her to live.

This is why I am putting my support behind Heart Valve Voice and their awareness raising cycle ride to EuroPCR in Paris. When Adrian told me that he and his nephew Jonathan would be joining the Heart Valve Voice cycle team and riding in honour of Lydia I was more than happy to do what I could to support this initiative. The only way we are going to get the life-changing treatment to more people who suffer from heart valve disease is to make both the general public and clinicians more aware of what to look out for and when to seek help.

I wish the team the best of luck!

You can find out more information about heart valve disease on the Heart Valve Voice website which supports various projects.

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