Dear Dr. Donohue • for the past five years I have known that Ihave aortic stenosis. I have no symptoms and no restrictions onwhat I do. My doctor says I need no treatment. Will I have ashortened life? I’m 55. — S.B.

Answer • “Stenosis” indicates narrowing. the aortic valve closeswhen the heart pumps blood out and into the aorta and the entirebody. Closure of the valve stops blood from leaking back into theheart. Because the valve and its opening have constricted, theheart has to pump harder to empty itself. That strains the heart,and, in time, 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 make their appearance. you might never need acorrection if the narrowing 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.

Dear Dr. Donohue • I have had three attacks of gallbladder painbecause of gallstones. My doctor is pushing me to have mygallbladder removed. Can’t these stones be treated in some otherway? — R.C.

Answer • have the surgery. you have had three attacks ofgallbladder pain; you’re bound to have more. you won’t find thesurgery as frightening as you imagine. often, it is done throughsmall incisions 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.

Write Dr. Donohue at P.O. Box 536475, Orlando, Fla.32853-6475