What degenerative change is primarily responsible for aortic stenosis in patients over 70 years old?

Aortic stenosis in older patients, especially those over 70 years of age, is primarily associated with the degenerative process of atherosclerotic calcifications. As individuals age, the aortic valve can undergo changes that include the accumulation of calcium deposits on the valve leaflets, which leads to progressive narrowing of the valve opening. This calcification is a consequence of wear and tear over time, as well as age-related changes in the connective tissue of the valve.

Atherosclerosis, which is the buildup of fats, cholesterol, and other substances in and on the artery walls, plays a significant role in the development of these calcific changes. Over time, this process can lead not just to coronary artery disease but also to degenerative changes of the aortic valve, resulting in aortic stenosis.

In contrast, rheumatic heart disease is more common in younger populations or in areas with inadequate healthcare access, where rheumatic fever remains prevalent. Congenital heart disease usually refers to structural abnormalities present from birth, which would not be the primary cause of aortic stenosis in the elderly population. Bicuspid aortic valves can lead to early onset of aortic stenosis, but this congenital condition affects a smaller cohort of individuals and