Researchers say severe heart disease affecting nearly 100,000 Australians will kill more than 50% of patients in five years without treatment.
Key points:
- Aortic stenosis is a condition that involves hardening of the aortic valve
- Research suggests that the number of new cases is approaching 10,000 a year
- One-third of cases are asymptomatic, but shortness of breath is an important sign
A study, published last year and partly funded by a heart valve company, modeled the number of Australians over the age of 55 with aortic stenosis, a hardening or “calcification” of the aortic valve.
Some people have a genetic predisposition to aortic stenosis, but high blood pressure, cholesterol, and diabetes are also linked to the disease, according to one author of the report.
David Playford, a cardiologist at the University of Notre Dame in Western Australia, said one of the hallmarks of the disease is that patients have no idea they have it.
“One of the characteristics of aortic stenosis is that it is often silent,” he said.
“Especially as people get older, from the age of 55 [and] especially those over 65, they may not know this is the problem.
“They have no symptoms at all or they might have some breathing during exercise.”
Clear strategy to detect “urgently needed” disease
Dr. Playford’s research is based on the results of the National Echo Database Australia, something he created to collect anonymous data from heart patients across the country.
This study found that aortic valve replacement was “associated with markedly improved survival.”
One of Dr. Playford’s patients, Shane Caulfield (pess), has had his aortic valve replaced. (ABC News: Nicolas Perpitch)
But his subsequent study noted that mortality estimates were not in line with the low mortality rates reported in some other trials.
The report found that as the population ages, the number of new cases of the disease is likely to approach 10,000 per year.
“From an individual perspective to that of society, it seems clear that due to the progressive aging of Australia’s population, a clear strategy is urgently required to optimally detect and manage a growing load of stenosis. aortic, ”says the study.
Dr. Playford urged people over the age of 55 to have a checkup, but warned that aortic stenosis could also occur in younger age groups, albeit less frequently.
Professor Playford says one of the hallmarks of the disease is that patients have no idea they have it. (ABC News: Nicolas Perpitch)
“In terms of risk … this is something that has really come out of our research, that the risk of death from this condition is actually greater than we had known before,” he said.
“This is an avoidable aortic death, as fixing the aortic valve … actually makes a big difference and can save their lives.”
Warning for symptoms
Dr. Playford said one-third of patients were asymptomatic or that people simply did not recognize the symptoms when they occurred.
“One of the problems that can happen with aortic stenosis is that there is only a slowdown,” he said.
He said when people ran out of breath and were uncomfortable, it slowed down and the symptoms subsided.
“So they just pass it on and say‘ it’s not really meaningful, it’s just part of aging, ’” Dr. Playford said.
“It’s quite common for symptoms to be under-reported and not thought to be significant. There are also people … who really have absolutely no symptoms.”
Dr Playford’s study, conducted with researchers from Australian hospitals, found that Australians with severe aortic stenosis had a double risk of dying without treatment.
He said treatment options included open heart or relatively recent transaortic surgery, which involved inserting a new valve through a catheter.
Shane Caulfield has a large scar after his open heart surgery. (ABC News: Nicolas Perpitch)
The study found that a number of open-heart surgeries a year could be replaced by the trans-catheter method.
The study, published in the peer-reviewed journal BMC Health Services, was funded by an unconditional grant provided by Edwards Lifesciences Australia, a heart valve manufacturer.
The patient goes from chest caving to 10 km walks
One of Dr. Playford’s patients, Shane Caulfield, first realized there might be something wrong with his health in 2017.
“[I] without knowing it, he started to lose his breath along the way, ”the 61-year-old said.
Mr. Caulfield was watched for three years before things got worse. (ABC News: Nicolas Perpitch)
One day, when he crouched down to take control of the television, he said he had a “headache” and that his chest began to “sink.”
Mr. Caulfield was referred to Dr. Playford, who watched him for three years before things got worse. At that time, breathing continued.
“I would probably walk a couple of hundred meters and [then] he began to fight. Also going up the stairs and that, ”Caulfield said.
Caulfield says the heart procedure has definitely extended his life. (ABC News: Nicolas Perpitch)
He underwent unrelated surgery on his knee and, when he regained consciousness of anesthesia, he felt very ill.
He was told he had to undergo open heart surgery to replace the aortic valve.
But Mr. Caulfield now walks up to 10 miles three or four times a week and after surgery his shortness of breath has disappeared.
He said the procedure had definitely extended his life.
“The pain of the operation and all that afterwards, it’s well worth it,” he said.
“Feel free to check yourself out.”