Aortic valve stenosis
Aortic valve stenosis
Aortic valve stenosis — or aortic stenosis — occurs when the heart's aortic valve narrows. This narrowing prevents the valve from opening fully, which obstructs blood flow from your heart into your aorta and onward to the rest of your body.
When the aortic valve is obstructed, your heart needs to work harder to pump blood to your body. Eventually, this extra work limits the amount of blood it can pump and may weaken your heart muscle, leading to symptoms, such as fatigue and dizziness.
If you have severe aortic valve stenosis, you'll usually need surgery to replace the valve. Left untreated, aortic valve stenosis can lead to serious heart problems.
Aortic valve stenosis ranges from mild to severe. Aortic valve stenosis signs and symptoms typically develop when narrowing of the valve is severe and can include:
The heart-weakening effects of aortic valve stenosis may lead to heart failure. Heart failure signs and symptoms include fatigue, shortness of breath, and swollen ankles and feet.
Aortic valve stenosis may not produce warning signs right away, making it difficult to detect at first. The condition is often discovered during a routine physical when a doctor hears an abnormal heart sound (heart murmur). This murmur may occur long before other signs and symptoms develop.
Depending on the amount of narrowing, an infant or child with aortic valve stenosis may have no symptoms, may tire easily or may have chest pain with vigorous physical activity.
When to see a doctor
Aortic valve stenosis is narrowing of the aortic valve. Many things can narrow this passageway between your heart and aorta. Causes of aortic valve stenosis include:
How your heart works
Blood returning to your heart enters the right upper chamber (right atrium). From there, blood empties into the right ventricle underneath. The right ventricle pumps blood into your lungs, where blood is oxygenated. Blood from your lungs then returns to your heart, but this time to the left side — to the left upper chamber (left atrium). Blood then flows into the left ventricle — your heart's main pump. With each heartbeat, the left ventricle forces blood through the aortic valve into the aorta, your body's largest artery.
Blood flows through your heart's chambers, aided by four heart valves. These valves open and close to let blood flow in only one direction through your heart:
The aortic valve — your heart's gateway to the aorta — consists of three tightly fitting, triangular-shaped flaps of tissue called leaflets. These leaflets connect to the aorta via a ring called the annulus.
Heart valves open like a one-way gate. The leaflets of the aortic valve are forced open as the left ventricle contracts and blood flows into the aorta. When all of the left ventricular blood has gone through the valve and the left ventricle has relaxed, the leaflets swing closed to prevent the blood that has just passed into the aorta from flowing back into the left ventricle.
A defective heart valve is one that fails to either open or close fully. When a valve doesn't close tightly, blood can leak backward. This backward flow through a valve is called regurgitation. When a valve narrows, the condition is called stenosis.
Chambers and the valves of the heart
A normal heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood ...
Normal heart and aortic valve stenosis
Aortic valve stenosis is a defect that narrows or obstructs the aortic valve opening, making it difficult for the heart to pump blood into the aorta. Mild cases may not have symptoms initially, but ...
Aortic valve stenosis isn't considered preventable. Some risk factors include:
Risk factors for aortic valve stenosis and atherosclerotic heart disease — such as high blood pressure, high cholesterol, type 2 diabetes and smoking — may indicate a link between the two.
Aortic valve stenosis — of any cause — can be a serious condition because it can weaken the heart. If the aortic valve is narrowed, the left ventricle has to work harder to pump a sufficient amount of blood into the aorta and onward to the rest of your body. In response, the left ventricle may thicken and enlarge. At first these adaptations help the left ventricle pump blood with more force. But eventually these changes weaken the left ventricle — and your heart overall.
Left unchecked, aortic valve stenosis can lead to life-threatening heart problems, including:
Preparing for your appointment
You're likely to start by first seeing your family doctor. After your initial appointment, your doctor may refer you to a doctor who specializes in the diagnosis and treatment of heart conditions (cardiologist).
Here's some information to help you prepare for your appointment, and what to expect from your doctor.
What you can do
Questions to ask your doctor at your initial appointment include:
Questions to ask if you are referred to a cardiologist include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
What you can do in the meantime
If exercise makes your symptoms worse, avoid exerting yourself physically until you've been seen by your doctor.
Tests and diagnosis
As part of a routine physical, your doctor uses a stethoscope to listen to your heart. He or she is listening for, among other things, an abnormal heart sound (heart murmur).
If your doctor discovers a heart murmur, he or she will discuss it with you. Many heart conditions, including aortic valve stenosis, can produce a heart murmur. In the case of aortic valve stenosis, the heart murmur results from turbulent blood flow through the narrowed valve.
These tests and others help your doctor determine how narrow or tight your aortic valve may be and how well your heart is pumping. Once aortic valve stenosis is discovered, your doctor will either recommend treatment or suggest careful monitoring.
Treatments and drugs
Medications sometimes can ease symptoms of aortic valve stenosis. However, the only way to eliminate aortic valve stenosis is surgery to repair or replace the valve and open up the passageway.
Surgery isn't always needed right away. If tests reveal that you have mild to moderate aortic valve stenosis and you have no symptoms, your doctor will schedule checkups to carefully monitor the valve so that surgery can be done at the appropriate time.
In general, surgery is necessary when narrowing becomes severe and symptoms develop. Some people never develop severe aortic valve stenosis, so they never need surgery. For others, the condition gets worse and surgery is necessary.
Therapies to repair or replace the aortic valve include:
Aortic valve stenosis can be treated effectively with surgery. However, you may still be at risk of irregular heart rhythms even after you've been treated for aortic valve stenosis. You may need to take medications to lower that risk. If your heart has become weakened from aortic stenosis, you may need medications to treat heart failure.
If you've had aortic valve replacement surgery, you may need to take antibiotics before certain dental or medical procedures due to the risk of infection in your heart tissue (endocarditis).
Some possible ways to prevent aortic valve stenosis include:
Once you know that you have aortic valve stenosis, your doctor may recommend that you limit strenuous activity to avoid overworking your heart.
If you're a woman of childbearing age with aortic valve stenosis, discuss pregnancy and family planning with your doctor before you become pregnant. Your heart works harder during pregnancy. How a heart with aortic valve stenosis tolerates this extra work depends on the degree of stenosis and how well your heart pumps. Should you become pregnant, you'll need evaluation by your cardiologist and obstetrician throughout your pregnancy, labor and delivery, and after delivery.
Last Updated: 2012-07-13
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