Researchers say a severe heart condition affecting close to 100,000 Australians will kill more than 50 per cent of sufferers within five years without treatment.
A study, published last year and partly funded by a heart valve company, modelled the number of Australians over the age of 55 with aortic stenosis — a hardening or "calcification" of the aortic valve.
Some people have a genetic predisposition to aortic stenosis but high blood pressure, cholesterol and diabetes are also linked to the condition, one report author says.
David Playford, a cardiologist with the University of Notre Dame in Western Australia, said one of the features of the condition is that sufferers have no idea they have it.
“One of the hallmarks of aortic stenosis is that it’s often silent,” he said.
"They either have no symptoms at all or could potentially just have some breathlessness during exercise."
Clear strategy to detect disease 'urgently required'
Dr Playford's research draws on findings from the National Echo Database Australia, something he set up to collect anonymised data from heart patients around the country.
That study found aortic valve replacement was "associated with markedly improved survival".
But his subsequent study noted mortality estimates were not in line with low rates of mortality reported in some other trials.
The report found that with an ageing population, the number of new cases with the condition was likely approaching 10,000 per year.
"From an individual to societal perspective, it seems clear that due to Australia's progressively ageing population, a clear strategy to detect and then optimally manage an increasing burden of aortic stenosis is urgently required," the study says.
Dr Playford urged people over 55 to get a check-up, but he warned aortic stenosis could happen in younger age groups as well, although less frequently.
"In terms of the risk … this is something that's really come out from our research, that the risk of death from this condition is actually higher than we had previously known in the past," he said.
"This is a preventable aortic death, as in fixing the aortic valve … actually it makes a huge difference and can save their lives."
Warning to be mindful of symptoms
Dr Playford said a third of sufferers were asymptomatic, or people just did not recognise the symptoms when they occurred.
"One of the problems that can happen with aortic stenosis is that there's just a slowing down," he said.
He said when people became breathless and it was uncomfortable, they just slowed down and the symptoms reduced.
"It's quite common for symptoms to be under-reported and not really thought to be significant. Also there are people ... that just really have absolutely no symptoms."
Dr Playford's study, undertaken with researchers from hospitals across Australia, found Australians with severe aortic stenosis had a two-fold increased risk of death without treatment.
He said treatment options included open-heart or the relatively recent trans-aortic surgery, which involved insertion of a new valve through a catheter.
The study found a certain number of open-heart surgeries per year could be replaced with the trans-catheter method.
The study, published in the peer-reviewed BMC Health Services journal, was funded by an unconditional grant provided by Edwards Lifesciences Australia, a maker of heart valves.
Patient goes from chest 'caving in' to 10km walks
One of Dr Playford's patients, Shane Caulfield, first noticed there might be something wrong with his health in 2017.
"[I] just unknowingly started losing breath along the way," the 61-year-old said.
One day when he bent down to pick up the TV remote, he said he had a "head rush" and his chest started "caving in".
Mr Caulfield was referred to Dr Playford, who monitored him for three years before things took a turn for the worse. In that time, the breathlessness continued.
"I would probably walk a couple of hundred metres and [then] started to struggle. Also walking up stairs and that," Mr Caulfield said.
He went in for an unrelated operation on his knee, and when he regained consciousness from the anaesthetic, he was very unwell.
He was told he had to bring forward an open heart surgery to replace the aortic valve.
But Mr Caulfield is now walking up to 10 kilometres three or four times a week, and post-surgery his breathlessness has disappeared.
He said the procedure had definitely prolonged his life.
"The pain of the operation and all that afterwards, it's well worth it," he said.
"Don't hesitate to get yourself checked out."
