Aortic stenosis causes


 * Associate Editor(s)-In-Chief: Mohammed A. Sbeih, M.D. [mailto:msbeih@perfuse.org]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Overview
Aortic stenosis can be categorized under two methods of causation: acquired and congenital.

Valvular Aortic Stenosis:
====Acquired ====
 * Calcific degeneration
 * Rheumatic fever
 * Infective endocarditis
 * Systemic lupus erythromatosis
 * Fabry's disease
 * Aortic sclerosis

====Congenital ====
 * Bicuspid aortic valve
 * Hypoplastic annulus
 * Three cuspid valve with commissural fusion

Subvalvular Aortic Stenosis:

 * Membranous diaphragm
 * Hypertrophic cardiomyopathy

Supravalvular Aortic Stenosis:

 * Hypoplasia of aorta
 * Hourglass constriction of aorta
 * Fibromembranous aortic lesion

Frequency of Underlying Causes of Aortic Stenosis
According to the Euro Heart Survey on valvular heart disease, the frequency of underlying causes of aortic stenosis was:
 * 1) Calcific degenration- 81.9%
 * 2) Rheumatic fever- 11.2%.
 * 3) Congenital- 5.6%
 * 4) Post-endocarditis- 1.3%

Causes of Aortic Valve Calcification

 * Aortic stenosis is most commonly caused by age-related progressive calcification of the normal tricuspid aortic valve (>50% of cases).
 * Other causes include:
 * Calcification of a congenital bicuspid aortic valve (30-40% of cases of cases of calcification) and
 * Acute rheumatic fever (less than 10% of cases of calcification)

Causes of More Rapid AS Progression

 * Normal valves have three leaflets (tricuspid), but some valves have two leafs (bicuspid). Typically, aortic stenosis due to calcification of a bicuspid valve appears earlier, in the 40s and 50s, whereas that due to calcification of a normal valve appears later, in the 70s and 80s. Hypertension, diabetes mellitus, hyperlipoproteinemia and uremia may speed up the process.

Cause of Aortic Stenosis as a Function of Age
The cause of aortic stenosis will vary with age.

Under Age 70

 * Bicuspid aortic valve: 50%
 * Postinflammatory: 255
 * Degenerative calcific: 18%
 * Unicommissural 3%
 * Hypoplastic: 2%
 * Indeterminant:2%

Over Age 70

 * Degenerative calcific: 48%
 * Bicuspid: 27%
 * Postinflammatory: 23%
 * Hypoplastic: 2%

Alphabetic Order

 * Age-induced calcification of normal tricuspid aortic valve with degenerative 'wear and tear'.
 * Congenital bicuspid aortic valve
 * Endocarditis
 * Fabry disease
 * Homozygous type II hypercholesterolemia
 * Ochronosis
 * Paget disease
 * Prosthetic aortic valve
 * Radiation treatment to the chest
 * Rheumatic fever (slowly progressive stenosis)
 * Subvalvular aortic stenosis
 * Supravalvular aortic stenosis
 * Williams syndrome, autosomal dominant trait is associated with supravalvular aortic stenosis