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Overview
What Is Aortic Valve Stenosis?
Aortic valve stenosis is a heart valve disease in which the aortic valve becomes narrowed and does not open fully. This smaller opening reduces blood flow from the heart to the body and can make the heart work harder. Aortic stenosis is more common with aging, but it can also result from a congenital valve difference or other valve problems. The term stenosis means narrowing; in this condition, the narrowing is in the valve rather than an artery.
Symptoms
Symptoms of Aortic Valve Stenosis
Mild aortic stenosis may cause no noticeable symptoms, and it may be found during a routine examination or heart test. Symptoms become more likely as the aortic valve becomes more narrowed and the heart has difficulty increasing blood flow during activity.
- Shortness of breath, especially during activity.
- Chest pain or pressure (angina).
- Fainting or near-fainting (syncope).
- Fatigue or unusual tiredness.
- Reduced ability to exercise.
- Ankle swelling.
Causes
Causes of Aortic Valve Stenosis
Aortic stenosis develops when the valve leaflets become thickened, stiff, or covered with calcium deposits. These changes reduce the valve opening and make it harder for the heart to pump blood forward. The cause may be related to aging, the valve’s structure from birth, or damage from another illness or treatment.
- Age-related calcific disease can cause calcium to build up and stiffen the aortic valve over time.
- A bicuspid aortic valve or another congenital valve difference can lead to earlier narrowing than usual.
- Rheumatic valve disease can scar and deform the valve after rheumatic fever.
- Prior chest radiation or inflammatory valve damage can injure the valve and contribute to narrowing.
Risk Factors
Risk Factors for Aortic Valve Stenosis
Some risk factors for aortic valve disease cannot be changed, such as age or the valve’s structure from birth. Others can be managed to support overall cardiovascular health, although managing them does not guarantee that aortic stenosis will be prevented. A clinician can help assess how these factors affect an individual’s risk.
| Nonmodifiable factors | Modifiable or manageable factors |
|---|---|
| Older age | High blood pressure |
| Congenital bicuspid aortic valve | High cholesterol |
| Family history of valve or heart disease | Diabetes |
| Prior rheumatic fever | Smoking |
| Inherited or structural valve differences | Kidney disease and its related cardiovascular effects |
Complications
Complications of Aortic Valve Stenosis
- The left ventricle may thicken as it works harder to push blood through the narrowed valve.
- Heart failure can develop when the heart can no longer pump effectively.
- Abnormal heart rhythms may occur as the heart becomes strained or enlarged.
- Pulmonary hypertension can develop when pressure backs up toward the lungs.
- Blood clots or stroke may become a risk, particularly when abnormal rhythms are also present.
- Advanced, untreated disease can be life-threatening and may result in death.
DO NOT IGNORE WORSENING SYMPTOMS
Symptoms can signal progression
New or worsening chest pain, fainting, breathlessness, or swelling needs prompt medical assessment, especially in someone known to have valve disease. Severe symptoms may require urgent care.
Diagnosis
How Aortic Valve Stenosis Is Diagnosed
Clinicians diagnose aortic stenosis by combining symptoms, medical history, heart sounds, and test results. A murmur can provide an important clue, but it is not enough by itself to confirm the condition or determine how severe it is. Testing also shows how the aortic valve and heart are functioning.
- An echocardiogram uses ultrasound to examine the aortic valve, measure blood flow, and assess the heart’s function.
- An electrocardiogram records the heart’s electrical activity and may show effects of strain or abnormal rhythm.
- A chest X-ray can provide information about the heart, lungs, and other possible causes of symptoms.
- Exercise testing may be used when appropriate to assess symptoms and heart function during activity.
- Cardiac CT can provide detailed images of the valve and calcium deposits.
- Cardiac catheterization may be used when more detailed pressure or coronary artery information is needed.
Treatment & Management
Aortic Stenosis Treatment and Management
Monitoring and medical management
People with mild or moderate disease may need regular follow-up and scheduled echocardiograms to watch for changes. Care may also include managing blood pressure, cholesterol, diabetes, and other related conditions. Medicines do not open a severely narrowed valve, but they may help manage blood pressure, fluid buildup, rhythm problems, or other cardiovascular risks under a clinician’s supervision.
Valve replacement
Valve replacement may be recommended for symptomatic or severe aortic stenosis. Surgical aortic valve replacement replaces the valve through an operation, while transcatheter aortic valve replacement places a new valve using a catheter. The choice depends on the valve anatomy, overall health, age, symptoms, and procedural risk.
Prevention
Can Aortic Valve Stenosis Be Prevented?
There is no guaranteed way to prevent all aortic stenosis, especially congenital valve differences and age-related calcific disease. However, reducing cardiovascular risks and treating related conditions may support heart health and help manage aortic valve disease. People with known valve disease should follow the monitoring plan recommended by their healthcare team.
- Do not smoke, and seek support to quit if you currently smoke.
- Manage blood pressure and cholesterol with lifestyle measures and prescribed treatment.
- Control diabetes according to your healthcare professional’s plan.
- Follow a heart-healthy eating pattern that emphasizes vegetables, fruits, whole grains, and balanced portions.
- Stay physically active as medically appropriate and follow any activity limits recommended for your valve condition.
- Attend follow-up appointments and echocardiograms if you have known aortic valve disease.
Outlook and Prognosis
Outlook and Prognosis
Mild aortic stenosis may remain stable for years with regular monitoring, although it can progress over time. Severe symptomatic disease can worsen and affect heart function and survival without effective treatment. The outlook depends on the degree of narrowing, symptoms, heart function, other health conditions, and how promptly appropriate care is provided.
When Should You See a Doctor
When Should You See a Doctor?
- Arrange an appointment for breathlessness that occurs with exertion.
- Seek medical advice for chest discomfort or pressure.
- Discuss fainting or near-fainting with a healthcare professional.
- Arrange an evaluation for unexplained fatigue.
- Tell a clinician about a reduced ability to exercise.
- Seek assessment for new or persistent ankle swelling.
- Ask for an examination if a new heart murmur has been detected.
SEEK URGENT HELP
Do not wait for symptoms to pass
Seek emergency medical help for severe or sudden chest pain, severe trouble breathing, fainting, new confusion, or symptoms that may indicate a stroke, such as sudden weakness, facial drooping, or trouble speaking. Do not treat this information as a substitute for emergency services.
Branches
1 topic
Aortic Valve Stenosis
Cardiovascular Surgery
