Aortic stenosis is a disease of the heart valve. It involves the narrowing of the aortic heart valve, which reduces blood flow.

The condition may cause a person to feel fatigued due to restricted blood flow. If aortic stenosis is causing symptoms, treatment can help prevent the disease from progressing.

This article provides an overview of aortic stenosis, including the causes, diagnosis, and treatment options.

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The heart has valves that allow blood to flow in and out of the heart to the lungs and body. The valves have flaps that direct blood flow and open and close with each heartbeat.

The left ventricle is the lower left chamber of the heart. The aortic valve lies between the left ventricle and the aorta. This valve directs blood to the aorta, the main artery that transports blood from the heart to the body.

Aortic stenosis is a narrowing of the aortic valve. Stenosis reduces blood flow from the heart to the aorta and the rest of the body.

The following are the most important signs of aortic stenosis:

Other symptoms can include:

In many cases, people do not experience symptoms until a significant reduction in blood flow occurs.

Aortic stenosis can be present at birth. In infants and children, symptoms may include:

  • fatigue with exertion
  • an inability to gain weight
  • difficulty with feeding
  • breathing difficulties

As aortic stenosis progresses, the muscular wall of the left ventricle may thicken due to the increased effort required to pump blood through the narrowed aortic valve.

Thickening of the left ventricle wall means there is less space inside the lower heart chamber. This reduces the amount of blood supplying the body and may lead to heart failure.

Heart failure is one of the most common complications of aortic stenosis. Other complications may include:

People with severe symptoms of aortic stenosis have a risk of sudden death and require prompt treatment.

Treatment can help reverse or slow the condition’s progression and help prevent complications.

Aortic stenosis may result from a congenital heart defect, which is a heart problem present at birth, such as a bicuspid aortic valve. People born with aortic stenosis may have an atypical heart valve with excess calcium buildup.

People may also develop aortic stenosis over time. For example, rheumatic heart disease resulting from rheumatic fever can cause inflammation and scarring in the heart valves, leading to aortic stenosis.

Additionally, end-stage kidney disease may result in calcium buildup of the heart valve, causing aortic stenosis.

Being older is a risk factor for aortic stenosis due to calcium buildup in the valve and scarring. This usually begins after a person is 60 years old, with symptoms appearing at 70–80 years old.

To diagnose aortic stenosis, a doctor will assess any symptoms and ask about the person’s medical history and any risk factors.

They may carry out a physical exam, including:

  • using a stethoscope to listen for any irregular heart sounds or rhythms, or specifically a heart murmur
  • feeling the pulse to see how strong it is
  • examining the abdomen for signs of an enlarged liver in a newborn

Doctors also use echocardiography to diagnose heart valve problems. Echocardiography uses sound waves to create a moving image of the heart and can show how blood is flowing through the valves and chambers.

Echocardiography also shows how much calcium buildup there is around the valve flaps. Doctors may also use CT and MRI scans to provide them with more information about a person’s heart function.

If people have no symptoms, they may not require any treatment. Instead, a doctor may monitor them to see if symptoms develop.

Aortic valve replacement is the first-line treatment for severe aortic stenosis, even for people with mild symptoms.

People may receive a mechanical or tissue valve replacement. A mechanical valve consists of durable metals and other materials. A tissue valve comes from a human donor or animal source.

Transcatheter aortic valve replacement (TAVR) is a procedure that uses minimally invasive surgery, rather than open heart surgery, to insert the valve through a small incision. A surgeon will place the new valve on top of the old one.

TAVR is preferred for older people with calcifications on the aortic valve. Doctors also use this procedure for individuals with other risk factors or those they consider high risk for surgical aortic valve replacement.

People with aortic stenosis who have no symptoms may require routine imaging tests. The timing of these checkups may depend on the severity of the condition.

For example, a person may need them at the following intervals:

  • every 3–5 years if their case is mild
  • every 1–2 years if their case is moderate
  • every 6–12 months if their case is severe

Certain factors may increase the risk of disease progression, including:

The outlook is excellent for people without symptoms. If people develop symptoms of aortic stenosis, treatment is important to restore blood flow and improve survival rates.

People may not experience any symptoms of aortic stenosis.

However, if they notice a lack of energy or a drop in regular physical activity, it may be a good idea to contact a doctor to check their heart function.

Aortic stenosis is a narrowing of the aortic valve in the heart. This can restrict blood flow to the rest of the body.

People with symptoms may require valve replacement surgery to prevent the condition from progressing.