Aortic stenosis causes

Aortic Stenosis Microchapters
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Transcatheter Aortic Valve Replacement (TAVR) TAVR vs SAVR Critical Pathway Patient Selection Imaging Evaluation Valve Types TAVR Procedure Post TAVR management AHA/ACC Guideline Recommendations
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2], Abdul-Rahman Arabi, M.D. [3], Keri Shafer, M.D. [4], Priyamvada Singh, MBBS [5], Mohammed A. Sbeih, M.D. [6]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [7]

Overview

Aortic stenosis can be categorized under two methods of causation: acquired and congenital. Research regarding the influence of preventative therapies on causation is mixed. More research is needed specifically looking at cholesterol lowering interventions and their role on disease onset.

Complete Differential Diagnosis for the Causes of Aortic Stenosis

Cardiovascular	.
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Some medications may cause aortic stenosis, such as
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	Radiation.
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	.
Iatrogenic	Radiation treatment to the chest.
Infectious Disease	Bacterial endocarditis where the vegetations may favor increase risk of stenosis.
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	.
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	.
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

The etiology of Left-Sided Outflow Obstruction can be divided into two broad categories:

1. Acquired Aortic Stenosis and
2. Congenital Left-Sided Outflow Obstruction

Major causes and predisposing conditions of aortic stenosis include acute rheumatic fever and bicuspid aortic valve. As individuals age, calcification of the aortic valve may occur and result in stenosis. This is especially likely to occur in people with a bicuspid aortic valve, but also occurs in the setting of perfectly normal valves as a result of age-induced 'wear and tear'. Typically, aortic stenosis due to calcification of a bicuspid valve occurs in the 4th of 5th decade of life, whereas symptomatic onset due to calcification of a normal valve tends to occur later - around the 7th or 8th decade.

Of the various forms of aortic stenosis, the calcific type is predominant. Since calcific aortic stenosis shares many pathological features and risk factors with atherosclerosis. As atherosclerosis may be prevented and/or reversed by cholesterol lowering, there has been interest in attempting to modify the course of calcific aortic stenosis by cholesterol lowering with statin drugs. Although a number of small, observational studies demonstrated an association between lowered cholesterol and decreased progression, and even regression, of calcific aortic stenosis. A large randomized clinical trial, published in 2005, failed to find any predictable effect of cholesterol lowering on calcific aortic stenosis. Researchers in 2007 study conversely demonstrated a slowing of aortic stenosis with the statin rosuvastatin. More research is necessary to further clarify the specific mechanisms of disease onset and the influence of interventional methodologies on overall causation.

Genetics

Congenital bicuspid valve is the most frequent form of congenital heart disease affecting approximately 1-2% of the population. 1/3rd of Supravalvular Aortic Stenosis cases are transmitted as an autosomal dominant trait as 60% of patients with supravalvular obstruction have Williams syndrome (supravalvular obstruction, intellectual impairment and facial abnormalities).