### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am 65 yrs. old female.  For about 20 yrs. Ive known Ive had a mitral valve prolapse, with just a flutter once in a while.  Id cough and it would go away.  About 3 yrs. ago I went through breast cancer, mastectomy and a tram reconstruction, nothing in my lymph nodes, so I had no further treatment needed, thankfully.  About  1 1/2 yrs. ago my doctor at my regular check up said she heard more gushing in my chest and advised me to get an echo.  I didnt really feel anything and put it  off until I needed to have more reconstuction surgery last Dec.and my plastic surgeon said the same thing, so I had it done.  My cardiologist said it was moderate to severe stenosis of the aeortic valve, and another new cardiologist gave me a card that I have a bicuspid aeortic valve. He did another echo and confirmed the first report.  It was a little hard to see, but he thought I had this from birth, but it looked like I only had 2 cusps instead of 3 and now have some calcium buildup there was why it had gotten more prounounced.  I had to have some more breast reconstruction done in December, but had it done under local.  I still need another procedure of some fat transfer done in the next months to help fill in a small sunken area above the breast.  Anyway my last cardiologist appt. in June said to wait for 6 months and have another echo, unless I have any bad symptoms before.  When I think about it it seems I have more fluttering.  Stress seems to upset it a little.  I really feel good, no pain, maybe a little shortness of breath when I climb stairways, but besides a little pounding every now and then I wouldnt know it. BP is low. But because I know it, and it was a big shock as I feel like Im falling apart and I do worry about it.  I sometimes maybe feel a little rushing in my head but thats pretty mild.  Im pretty healthy or thought I always was til now.  Im 58 weigh 148 # have some joint issues with my hips, knees and recently my shoulders, and Im more comfortable on a bike than walking because of this.  Seems to be easier on my joints.  I went to Curves for 9 years and both in our area closed in the last 6 mos., so i try to do some form of exercise at home.  Thought I could wait til I could have a non invasive approach to the valve, I just find it really hard to think of having my chest split, especially now since Ive had all my reconstruction and am in fair order there. My cardiolgist doesnt recommend the non invasive approach. And I hear the valves dont last that long and dont want to think of more surgeries down the road.  I take one drug arimidex for the breast cancer for another 2 years.  Im ready to get rid of it, as I think it has precipitated some of my joint problems.  So far my dexi scans are o.k   What are my options and warnings.

### output:

You are having aortic stenosis. First you need to regularize your heart check up and regular echo to know the heart functions. If cardiologist recommend you the surgery then you should undergo it. Best option available is valve replacement. Metallic valve have good life and bioprosthetic ones have short life span. However after metallic valve replacement will need blood thinners post operative. But in short if you surgery you should undergo it because without surgery prognosis is bad and survival is short