Cardiology
stenosis, characterised by the narrowing of the aortic valve, presents unique challenges for women. Although it affects both genders, women may encounter specific hurdles because of differences in symptom presentation and diagnostic pathways. Studies indicate that women with aortic
stenosis tend to manifest symptoms later in life, potentially influenced by hormonal and anatomical variances. Furthermore, women frequently exhibit atypical symptoms, which can be overlooked or misunderstood, resulting in delayed diagnosis and treatment. Recognising these gender-specific nuances are essential for healthcare providers to ensure prompt intervention and improved outcomes for women with aortic stenosis. During the diagnostic process for aortic
stenosis, physicians take a careful history clarifying symptoms and risk factors. With a stethoscope they listen to the heart to detect murmurs that could indicate issues with the aortic valve.
If a murmur is detected, a patient will
be referred for an echocardiogram to help diagnose valve disease. This checks the structure of the heart and valves and assesses the strength of the heart muscle. Aortic stenosis is a very common valve disorder, which if diagnosed late or untreated can lead to sudden death or heart failure. The severity of aortic stenosis is often
underestimated in women. This is due to a number of factors, including less calcification on the aortic valve than men, and a tendency to have a lower gradient across the aortic valve due to smaller left ventricular volumes and a reduced stroke volume. In some cases, the diagnosis of severe aortic stenosis requires more specialised echocardiographic techniques which are not readily available outside of a hospital setting. Evidence shows that women are less
frequently referred for interventions than men, such as aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI), and at a later stage of disease. On average, they wait three months longer than men for treatment. AVR and TAVI are life- saving procedures for symptomatic severe aortic stenosis, relieving symptoms, increasing life expectancy, and improving quality of life.
Treatment options Treatment options for aortic stenosis depend on the severity of the condition and the presence of symptoms. In cases of mild or moderate aortic stenosis without symptoms, regular monitoring by a healthcare provider may be sufficient. However, if symptoms such
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life-threatening condition are confronted with extensive delays in receiving essential treatment. In a comprehensive examination of TAVI waiting times within the NHS in 2019, it was discovered that, across 23 centres surveyed, the median wait time from referral to TAVI stood at 141 days — more than 20 weeks.4 It is also estimated that the median time
from the first contact in secondary care to receiving an aortic valve replacement (AVR) is three months longer for women than men.5 prospective study5
as chest pain, shortness of breath, or fainting occur, or if the stenosis becomes severe, intervention may be necessary. Throughout the NHS, there is a significant disparity between the demand for TAVI and the available capacity. Consequently, individuals afflicted with this debilitating and potentially
In a of 3,632 with AS (42% of them
women) women were less likely to be referred for valve intervention and more likely to die than men. It was demonstrated there is a higher five-year mortality among women than men and longer waits for AVR among women. Women tended to be older and more
symptomatic than men. The study concluded breathe difference
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