DefinitionThe aorta is the main artery that carries blood out of the heart to the rest of the body. Blood flows out of the heart and into the aorta through the aortic valve. In aortic stenosis, the aortic valve does not open fully. This decreases blood flow from the heart.Alternative NamesAortic valve stenosis; Rheumatic aortic stenosis; Calcific aortic stenosisCausesAs the aortic valve narrows, the left ventricle has to work harder to create more pressure to pump blood out through the valve. To do this extra work, the muscles in the ventricle walls become thicker. This can lead to chest pain.As the pressure continues to rise, blood may back up into the lungs. Severe aortic stenosis can limit the amount of blood that reaches the brain and rest of the body.Aortic stenosis may be present from birth (congenital), but most often it develops later in life. Children with aortic stenosis may have other conditions present from birth.Aortic stenosis mainly occurs due to the buildup of calcium deposits that narrow the valve. This is called calcific aortic stenosis. The problem generally affects older people.Calcification of the valve happens sooner in patients who are born with abnormal aortic or bicuspid valves. In rare cases, calcification can develop more quickly when a person has received chest radiation (such as for cancer treatment).Another cause is rheumatic fever. This condition can develop after strep throat or scarlet fever. Valve problems do not develop for 5 – 10 years or longer after rheumatic fever occurs. Rheumatic fever is becoming rarer in the United States.advertisementAortic stenosis occurs in about 2% of people over 65 years of age. It occurs more often in men than in women.SymptomsMost people with aortic stenosis do not develop symptoms until the disease is advanced. The diagnosis may have been made when the health care provider heard a heart murmur and performed tests.Symptoms of aortic stenosis include:Chest discomfort: The chest pain may get worse with activity and reach into the arm, neck, or jaw. The chest may also feel tight or squeezed.Cough, possibly bloodyBreathing problems when exercisingBecoming easily tiredFeeling the heart beat (palpitations)Fainting, weakness, or dizziness with activityIn infants and children, symptoms include:Becoming easily tired with exertion (in mild cases)Failure to gain weightPoor feedingSerious breathing problems that develop within days or weeks of birth (in severe cases)Children with mild or moderate aortic stenosis may get worse as they get older. They are also at risk for a heart infection called bacterial endocarditis.Exams and TestsA heart murmur, click, or other abnormal sound is almost always heard through a stethoscope. The health care provider may be able to feel a vibration or movement when placing a hand over the heart. There may be a faint pulse or changes in the quality of the pulse in the neck.Blood pressure may be low.Aortic stenosis is most often detected and then followed using a test called an echocardiogram.The following tests may also be performed:ECGExercise stress testingLeft cardiac catheterizationMRI of the heartTransesophageal echocardiogram (TEE)TreatmentRegular checkups by a health provider may be all that is needed if you have no symptoms or only mild symptoms. The health care provider should ask about your health history, do a physical exam, and perform an echocardiogram.People with severe aortic stenosis may be told not to play competitive sports, even if they have no symptoms. If symptoms do occur, strenuous activity must often be limited.Medicines are used to treat symptoms of heart failure(link) or abnormal heart rhythms (most commonly atrial fibrillation). These include diuretics (water pills), nitrates, and beta-blockers. High blood pressure should also be treated. If aortic stenosis is severe, this treatment must be done carefully so blood pressure does not drop to dangerously low levels.In the past, most patients with heart valve problems were given antibiotics before dental work or an invasive procedure such as colonoscopy. The antibiotics were given to prevent an infection of the damaged heart. However, antibiotics are now used much less often before dental work and other procedures. Check with your health care provider to find out whether you need antibiotics.People with this condition should stop smoking and be treated for high cholesterol.Surgery to repair or replace the valveis often done for adults or children who develop symptoms. Even if symptoms are not very bad, the doctor may recommend surgery based on some test results.A less invasive procedure called balloon valvuloplasty may be done instead of surgery.advertisementA balloon is placed into an artery in the groin, threaded to the heart, placed across the valve, and inflated. However, narrowing often occurs again after this procedure.A newer procedure done at the same time as valvuloplasty can implant an artificial valve. This procedure is most often done in patients who cannot have surgery, but is becoming more common.Some children may need aortic valve repair or replacement. Children with mild aortic stenosis may be able to take part in most activities.Outlook (Prognosis)The outcome varies. The disorder may be mild and not produce symptoms. Over time, the aortic valve may become more narrow, and as a result, more severe heart problems may develop, such as.Atrial fibrillation and atrial flutterBlood clots to the brain (stroke), intestines, kidneys, or other areasFainting spells, called syncopeHeart failureHigh blood pressure in the arteries of the lungs (pulmonary hypertension)The results of aortic valve repair are often excellent. To get the best treatment, go to a center that regularly performs this type of surgery.When to Contact a Medical ProfessionalCall your health care provider if you or your child has symptoms of aortic stenosis.Also contact your doctor right away if you have been diagnosed with this condition and your symptoms get worse or new symptoms develop.ReferencesBonow RO, Carabello BA, Chatterjee K, de Leon AC Jr., Faxon DP, Freed MD, et al; 2006 Writing Committee Members; American College of Cardiology/American Heart Association Task Force. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients with Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2008;118:e523-e661.Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 75.Nishimura RA, Carabello BA, Faxon DP, et al. ACC/AHA 2008 guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(8):676-685.Otto CM, Bonow RO. Valvular heart disease. In: Bonow RO, Mann DL, Zipes Dp, Libby P, Braunwald E, eds. Braunwalds Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. St. Louis, Mo: WB Saunders; 2011:chap 66.Review Date:5/1/2013Reviewed By:Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
NEW YORK — For the second time in his young career, Eduardo Rodriguez showed an impressive amount of poise while facing Boston’s biggest rival.Certainly, that’s something positive the last-place Red Sox can take out of this season.Rodriguez made one big mistake in seven sharp innings, a homer to Jacoby Ellsbury, but the Red Sox failed to break through against CC Sabathia and lost to the New York Yankees 2-1 on Aug. 6.“I know it’s the Yankees, but like I said, they have the bat, I have the ball, so I just try to make good pitches,” Rodriguez said.The 22-year-old lefty beat New York at Fenway Park on July 11, tossing 6 2-3 solid innings. He was just as good this time at an unfriendly — and packed — Yankee Stadium.Rodriguez (6-4) allowed six hits and two runs. He walked two — one an intentional pass to Alex Rodriguez that loaded the bases in the fifth — and struck out five.A-Rod had an RBI double in the third, but Eduardo Rodriguez was cool on the mound.He gave up a pair of singles to start the fifth and, when a sacrifice put runners on second and third for Alex Rodriguez, who already had two hits, Eduardo Rodriguez walked him to face Mark Teixeira.The slugger popped out foul to the catcher, and Chris Young popped up to shortstop to end the threat.“A good young arm,” Ellsbury said. “He definitely has a bright future ahead of him.”Justin Wilson (4-0) struck out three batters in the seventh to help the Yankees take two of three from the Red Sox, who are 48-61.Dellin Betances gave up a hit in the eighth. Andrew Miller put two on in the ninth but struck out Rusney Castillo to remain perfect in 24 save chances.Ellsbury connected with two outs in the seventh.The former Red Sox center fielder was in a 3-for-23 slump entering the game. His average had dipped from .322, when he came off the disabled list on July 8, to .277 coming in.Sabathia left his previous start with dehydration, wilted by the Texas heat. He was ornery in this outing, yelling at plate umpire Rob Drake over a called ball early on and giving a fist-pumping shimmy after using a 94 mph fastball to strike out David Ortiz with the bases loaded to end the fifth.“He threw me some good pitches,” Ortiz said. “Tonight was the best I have seen him in a while. He was locating his pitches well.”The big left-hander had just walked Xander Bogaerts following Castillo’s run-scoring single that ticked off the glove of diving shortstop Didi Gregorius to tie it 1-all. Castillo’s hit came right after Sabathia walked .100 hitter Jackie Bradley Jr.Pitching on an extra day of rest, Sabathia stalked around the mound and used pinpoint control to strike out eight. He yielded three hits and three walks after allowing five runs in each of his previous two starts.“I was fired up,” Sabathia said.(HOWIE RUMBERG, AP Baseball Writer)TweetPinShare0 Shares
On this file and others she said, “I ran again because we have more to do. I want to see this work through.”ACTRA Toronto is the largest organization within ACTRA, representing over 15,000 of Canada’s 21,000 professional performers working in the English-language recorded media in Canada. As an advocate for Canadian culture since 1943, ACTRA is a member-driven organization that continues to secure rights and respect for the work of professional performers..ACTRA TORONTO SOCIAL MEDIA LINKSWEBSITE: https://www.actratoronto.com/FACEBOOK: https://www.facebook.com/ACTRAToronto/TWITTER: https://twitter.com/ACTRATorontoTHERESA TOVA SOCIAL MEDIA LINKSFACEBOOK: https://www.facebook.com/theresa.tovaTWITTER: https://twitter.com/TTovatweetIMDB: https://www.imdb.com/name/nm0869797/WIKIPEDIA: https://en.wikipedia.org/wiki/Theresa_Tova LEAVE A REPLY Cancel replyLog in to leave a comment Login/Register With: Advertisement Advertisement Toronto, January 9, 2019 – At its January meeting, ACTRA Toronto’s governing council unanimously voted to elect incumbent President Theresa Tova to a second two-year term.In her acceptance speech, President Tova said she was proud of a fair renewed National Commercial Agreement and a renewed Independent Production Agreement which “achieved real gains for performers.”Addressing the subject of harassment in the entertainment industry and the acknowledged leadership she has demonstrated in the pursuit of industry cultural change, she said, “Too many of our members were accepting bullying and harassment as part of the deal we cut with the industry. So many of us had been told to shut up, and not complain or make waves.” Facebook Advertisement Twitter
Colombia coach Jose Pekerman is expected to make a last minute decision as to whether to play James Rodriguez in their all-important second round World Cup clash against England considering his state of health or not.Initial scans have shown that the injury suffered by the Bayern Munich star in their final Group H encounter against Senegal are better than first feared. With the scans showing he suffered no ligaments damage or muscle tear.Pekerman has given his star player every chance of making the tie against England, saying the decision to James would be a last minute one, Mirror claims.Zidane hails ‘quality’ James Rodriguez after Real Madrid’s win Andrew Smyth – September 14, 2019 Zinedine Zidane reserved special praise for James Rodriguez after his starring role in Real Madrid’s 3-2 win over Levante.The former Madrid man did not train together with his teammates in front of the media on Monday, he was seen to be working on his core alone with the hope of getting fit for the second round game on Tuesday evening.James Rodriguez who won the golden boot at the last World Cup in Brazil with six goals came into this tournament with an injury, only playing 90 minutes in the second group game against Poland and coming on as a substitute in the first game against Japan.Should the injury force him out of the tie, Colombia would be looking towards the 25-year-old Juan Quintero, who has impressed so far at this World Cup for their creative spark.