Dear Dr. Donohue: For the past five years, I have known I haveaortic stenosis. I have no symptoms and no restrictions on what Ido. my doctor says I need no treatment. I’m happy about that. I’dlike to know when I will. Will I have a shortened life? I’m 55. -S.B.

A: “Stenosis” indicates narrowing. The aortic valve closes whenthe heart pumps blood out and into the aorta and the entire body.Closure of the valve stops blood from leaking back into the heart.because the valve and its opening have constricted, the heart hasto pump harder to empty itself. that strains the heart and, intime, leads to heart failure.

Stenosis is relative. its danger and its consequences depend onhow narrow the opening and valve are. Doctors can get an accuratepicture of the valve’s dimensions through an echocardiogram, asound wave picture of the heart.

When the valve and its opening reach a critical size, decisionsare made about the best treatment. often, it’s surgery with theinstallation of an artificial valve.

If a severely narrowed valve goes untreated, three symptomsdevelop: chest pain on activity (angina), shortness of breath andfainting spells. Death occurs within three of fewer years unless anew valve is put in place. Surgery is usually performed well beforethese signs appear. you might never need a correction if thenarrowing process stops.

You probably wonder how you acquired the valve problem. Youmight have been born with a valve that had minor defects, whichpromoted narrowing. Calcifications could have settled on the valve.Or you might have had rheumatic fever as a child, which causedvalve deformity.

The booklet on heart valve disorders gives a comprehensive viewon these valves and their treatment. Readers can obtain a copy bywriting: Dr. Paul Donohue – no. 105, Box 536475, Orlando, FL32853-6475. Enclose a check or money order (no cash) for $4.75 withthe recipient’s printed name and address. please allow four weeksfor delivery.

Dear Dr. Donohue: I have had three attacks of gallbladder paindue to gallstones. my doctor is pushing me to have my gallbladderremoved. The prospect of surgery doesn’t thrill me. Can’t thesestones be treated in some other way? how does my body functionwithout a gallbladder? – R.C.

A: Have the surgery. you have had three attacks of gallbladderpain; you’re bound to have more. you won’t find the surgery asfrightening as you imagine. often, it is done through smallincisions with the guidance of a scope.

The body does quite well without a gallbladder. It’s a reservoirfor bile, which is made in the liver. When a person eats a mealthat has fat in it, as most meals do, the gallbladder contracts,sending a jet of bile into the digestive tract to promote fatdigestion. Without a gallbladder for storage, bile drips into thedigestive tract on a constant basis; that works out well.

Medicines can dissolve gallstones. They take a long time towork, and the stones have to be small. Frequently, the stonesre-form after medicines are stopped.

Dear Dr. Donohue: I was an alcoholic. I shouldn’t say that. Ishould say I am a recovering alcoholic.

I have heard so much about drinking wine for heart benefits thatI wonder if I ought to take a glass of it a day. I haven’t had anyalcohol for 10 years. I’m scared that this could get me startedagain. – W.W.

A: Alcohol, red wine in particular, offers protection againstheart disease. but it doesn’t offer such overwhelming protectionthat you’re missing out on a life-saving remedy. Stay on the leanside, control your blood pressure, be as active as you can andwatch your cholesterol; you will derive many more benefits than youwould by drinking a daily glass of wine. you don’t want to undo 10years of sobriety.

Dr. Paul Donohue writes for North America Syndicate. Sendletters to Box 536475, Orlando, FL 32853-6475.