[Aortic valve stenosis: current physiopathological and therapeutic aspects]

Area of Science:

• Cardiology
• Valvular Heart Disease
• Epidemiology

Context:

• Changing epidemiological profile of valvulopathies due to increased life expectancy and decreased rheumatic diseases.
• Focus on acquired calcific aortic stenosis, a common valvular heart disease.
• Understanding the late onset of symptoms in calcific stenosis due to ventricular compensation.

Purpose:

• To analyze the causes, pathological anatomy, physiopathology, and therapy of aortic valvular stenosis.
• To differentiate acquired calcific stenosis from other forms.
• To establish clinical criteria for surgical intervention.

Summary:

• Aortic valvular stenosis presentation is shifting, with symptoms like angina, syncope, or decompensation being key indicators for surgical intervention over elevated gradient alone.
• Acquired calcific stenosis can present late due to the heart's compensatory mechanisms.
• Treatment options include traditional valvular replacement and balloon valvuloplasty, which provides palliative benefits by increasing valvular area and improving ventricular function, especially when major surgery is contraindicated.

Impact:

• Provides updated clinical guidelines for managing aortic valvular stenosis.
• Highlights the role of balloon valvuloplasty as a palliative measure.
• Contributes to understanding the evolving landscape of valvular heart disease management in aging populations.