It's Medical Monday

Good morning Aortic Hope Family! Welcome to another edition of Medical Monday. Did you know that men and women can experience aortic stenosis in different ways? These differences go beyond anatomy; they’re deeply connected to hormones, imaging, and how our hearts respond to stress.

Whether you’re here to learn for yourself, support a loved one, or just out of curiosity, understanding these gender-specific nuances could be a game-changer in how we approach diagnosis and treatment. Let’s break it down and explore how the latest research is helping doctors tailor care for everyone.

Gender-Specific Insights Into Aortic Stenosis

1. What is Aortic Stenosis?

Aortic stenosis (AS) is a condition where the heart's aortic valve narrows, restricting blood flow. Over time, this can lead to symptoms like fatigue, chest pain, and shortness of breath. If untreated, it can significantly impact heart function and life expectancy.

2. Key Differences Between Men and Women

   1. How the Disease Develops:

      
      

      1. Men: AS often involves heavy calcium buildup, making the valve stiff.

      2. Women: The condition is more associated with fibrosis (scarring) than calcification.

         
         

   2. Hormonal Influence:

      
      

      1. Estrogen: Acts as a protective shield for premenopausal women, delaying calcification.

      2. Testosterone: Promotes calcification, leading to faster disease progression in men.

         
         

   3. Heart’s Response:

      
      

      1. Women: Tend to develop concentric remodeling (heart walls thicken symmetrically).

      2. Men: Often show eccentric remodeling (thickening is uneven).

         
         

3. Challenges in Diagnosis

   1. Women’s valves often appear less calcified on imaging, which can lead to underdiagnosis.

      
      

   2. Women may also report subtler symptoms like dizziness or fatigue, making the condition harder to detect without advanced imaging techniques.

      
      

4. Treatment and Outcomes

   1. Better Survival Rates for Women:

      1. Women often experience better outcomes after procedures like transcatheter aortic valve replacement (TAVR), even though they are at higher risk of certain complications, such as bleeding.

         
         

   2. Delayed Treatment:

      1. Unfortunately, women are often referred for treatment later than men, usually when the disease has progressed further.

Why This Matters

Recognizing these differences can lead to better diagnosis and care:

• Tailored imaging criteria for women can prevent missed diagnoses.

• Increased awareness about hormonal influences and symptom presentation helps doctors provide more accurate and timely interventions.

Understanding these gender-specific differences isn’t just science—it’s a way to make care more effective, equitable, and personal.

Thank you for joining me this Medical Monday! Let's keep the conversation going if you have questions or want to learn more. Every bit of knowledge takes us closer to better health outcomes for everyone. If you're interested in this topic, click the link below to learn more!

Stay informed,

Samantha

Dahou, A., et al. Sex-Related Differences in the Pathophysiology, Cardiac Imaging, and Clinical Outcomes of Aortic Stenosis: A Narrative Review. J. Clin. Med. 2024, 13, 6359. (https://doi.org/10.3390/jcm13216359).