Aortic Valve Sclerosis

Aortic sclerosis is a condition that has no associated symptoms. It can cause a mild heart murmur detected by your physician during a physical examination. A murmur is a “whooshing” sound created by turbulent blood flow across the valve and is heard with a stethoscope. The actual diagnosis is made when an echocardiogram is performed, either to follow up on the murmur or in many cases to evaluate the heart for other unrelated reasons. 

An echocardiogram uses sound waves to directly visualize the heart and its valves, and in this case shows thickening or calcification of the aortic valve leaflets. Despite these abnormalities the valve still functions normally overall as the thickened leaflets still move well. Therefore, there is no obstruction of blood flow out of the heart chamber.

As the changes in the valve worsen over time, usually many years, the valve can become “sticky” and cause obstruction of flow and the need for the heart to work harder and generate higher pressures to pump blood out to the body. This is then referred to as “aortic stenosis” which can progress to cause significant symptoms and advanced heart problems.

Aortic sclerosis is primarily associated with aging, and it shares several risk factors with atherosclerosis. The main causes and risk factors include:

• Age: The risk increases significantly with age, particularly in individuals over 60.
• Gender: Males are more commonly affected than females.
• Atherosclerosis: The risk factors for atherosclerosis, such as high cholesterol, high blood pressure, smoking, and diabetes, also contribute to the development of aortic sclerosis.
• Chronic kidney disease: While not directly associated, moderate chronic kidney disease can be a contributing factor.
• Bicuspid aortic valve: This congenital condition refers to an aortic valve that has only two leaflets instead of the usual 3. These valves are predisposed to develop calcification and sclerosis, and eventually aortic stenosis earlier in life than normal valves. 

Aortic sclerosis does not need specific treatment since it doesn't significantly block blood flow. However, it's important to manage cardiovascular risk factors like high blood pressure, high cholesterol, diabetes and smoking. Statins can help with high cholesterol, but their effect on aortic sclerosis progression is uncertain. 

Understanding the problem with close monitoring for new symptoms (such as chest pain, shortness of breath or passing out) can help your physician know when to do more testing. Occasional echocardiograms may be needed to check for progression to aortic stenosis. Lifestyle changes, such as a healthy diet and regular exercise, are also crucial for reducing overall cardiovascular risk.