DEAR DR. DONOHUE: For the past five years I have known that I have aortic stenosis. I have no symptoms and no restrictions on what I do. My doctor says I need no treatment. I’m happy about that. Will I have a shortened life? I’m 55. — S.B.
ANSWER: “Stenosis” indicates narrowing. The aortic valve closes when the heart pumps blood out and into the aorta and the entire body. Closure of the valve stops blood from leaking back into the heart. Because the valve and its opening have constricted, the heart has to pump harder to empty itself. That strains the heart, and, in time, leads to heart failure.
Stenosis is relative. Its danger and its consequences depend on how narrow are the opening and valve. Doctors can get an accurate picture of the valve’s dimensions through an echocardiogram, a sound wave picture of the heart.
When the valve and its opening reach a critical size, decisions are made about the best treatment. Often, it’s surgery with the installation of an artificial valve.
If a severely narrowed valve goes untreated, three symptoms develop: chest pain on activity (angina), shortness of breath and fainting spells. Death occurs within three or fewer years unless a new valve is put in place. Surgery is usually performed well before these signs make their appearance. You might never need a correction if the narrowing process stops.
You probably wonder how you acquired the valve problem. You might have been born with a valve that had minor defects, which promoted narrowing. Calcifications could have settled on the valve. Or you might have had rheumatic fever as a child, which caused valve deformity.
The booklet on heart-valve disorders gives a comprehensive view on these valves and their treatment. Readers can obtain a copy by writing: Dr. Donohue — No. 105W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I have had three attacks of gallbladder pain due to gallstones. My doctor is pushing me to have my gallbladder removed. The prospect of surgery doesn’t thrill me. Can’t these stones be treated in some other way? How does my body function without a gallbladder? — R.C.
ANSWER: Have the surgery. You have had three attacks of gallbladder pain; you’re bound to have more. You won’t find the surgery as frightening as you imagine. Often, it is done through small incisions with the guidance of a scope.
The body does quite well without a gallbladder. It’s a reservoir for bile, which is made in the liver. When a person eats a meal that has fat in it, as most meals do, the gallbladder contracts, sending a jet of bile into the digestive tract to promote fat digestion. Without a gallbladder for storage, bile drips into the digestive tract on a constant basis; that works out well.
Medicines can dissolve gallstones. They take a long time to work, and the stones have to be small. Frequently, the stones re-form after medicines are stopped.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
© 2011 North America Synd., Inc. All Rights Reserved