Stenosis
Stenosis is a medical condition characterized by the narrowing of various anatomical structures in the body, including arteries, heart valves, and the spinal canal. The underlying causes of stenosis vary by location; for instance, arterial stenosis often results from plaque buildup due to cholesterol and fats, while heart valve stenosis may arise from congenital defects, infections, rheumatic fever, or aging. In the case of spinal stenosis, factors like deteriorating or herniated disks, arthritis, and spinal deformities contribute to the condition.
Symptoms can differ based on the affected area. Arterial and heart valve stenosis may lead to high blood pressure, chest pain, shortness of breath, or even severe outcomes like heart attacks or strokes. Conversely, spinal stenosis commonly presents as pain or numbness in the back, neck, legs, or buttocks, which tends to worsen with standing or physical activity.
Treatment options for stenosis often include medications, such as blood thinners and cholesterol-lowering drugs, as well as antibiotics for infections. Various procedures, including balloon angioplasty, stent placement, and surgeries for valve or spinal correction, are also available to alleviate symptoms and address the underlying issues.
Subject Terms
Stenosis
Also known as: Stricture, arctation, coarctation
Anatomy or system affected: Blood vessels, circulatory system, gastrointestinal system, heart, spine
Definition: An abnormal narrowing or constriction of a canal or passageway in the body that is caused by the buildup of cholesterol, fats, or other substances (called plaque); the swelling or overgrowth of cells, tissue, or an organ; or a deformity.
Causes: Buildup of plaque; swelling of tissue, cells, or organ; deformity
Symptoms: Varies by area affected
Duration: Temporary or permanent
Treatment: Various medications, invasive interventions, surgery
Causes and Symptoms
Stenosis can occur in many areas of the body, such as an artery, a heart valve, or the vertebral (spinal) canal. It may stem from many causes, depending on the area affected. In an artery, stenosis occurs with the buildup of cholesterol, fats, or other substances, called plaque. A stenotic heart valve can be a congenital birth defect or the result of an infection (endocarditis), rheumatic fever, or aging. The septum, or dividing wall in the heart, can enlarge and lead to an abnormally small ventricle, or heart chamber. Spinal stenosis is caused by a deteriorating or herniated disk, arthritis, tissue enlargement inside the spinal canal, deformities of the spinal column (Paget’s disease), or an injury.
Symptoms of this disorder relative to an artery, heart valve, or ventricle include high blood pressure, pain or tightness in the chest (angina pectoris), shortness of breath, dizziness or fainting with exertion, fatigue, palpitations (rapid heartbeat), or a heart murmur. In more severe cases, it can develop into a heart attack or stroke. The symptoms of spinal stenosis include back, neck, leg, or buttocks pain or numbness that worsens with standing or exercising.
Treatment and Therapy
Medication is commonly used to treat or relieve the symptoms caused by a stenosis. Blood thinners such as aspirin and warfarin allow easy passage of blood through a stenosed area to lower the risk of high pressure. Cholesterol-lowering medications slow the buildup of plaque in the artery. Antibiotics help repair damaged heart valves, with a long course and high dosage used if the cause is infectious endocarditis. Finally, anti-inflammatory medications or steroid injections are the first line of treatment for spinal stenosis.
A number of interventions can be used to correct this disorder. Balloon angioplasty flattens plaque buildup, while valvuloplasty widens the valve opening. A stent, or wire mesh tube, is often inserted following an angioplasty to hold the artery open. One alternative is atherectomy, in which a laser or rotary shaver breaks up the plaque. If a patient has multiple severely stenosed arteries, then coronary artery bypass surgery may be recommended. Finally, artificial heart valve replacement surgery or corrective surgery for spinal stenosis may be warranted.
Bibliography:
"Aortic Valve Stenosis." Mayo Clinic, 18 Aug. 2022, www.mayoclinic.org/diseases-conditions/aortic-stenosis/symptoms-causes/syc-20353139. Accessed 9 Aug. 2023.
Dorland’s Illustrated Medical Dictionary. 32nd ed. Philadelphia: Elsevier/Saunders, 2012.
Dugdale, David C., III, Shabir Bhimji, and David Zieve. “Pulmonary Valve Stenosis.” MedlinePlus, June 7, 2012.
Dugdale, David C., III, Michael A. Chen, and David Zieve. “Aortic Stenosis.” MedlinePlus, June 4, 2012.
“Questions and Answers about Spinal Stenosis.” National Institute of Arthritis and Musculoskeletal and Skin Diseases, Jan. 2013.