What is stenosis of the heart valves?

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The following types of stenosis of the heart can occur:

• Aortic stenosis: Aortic stenosis involves the narrowing of the opening of the aortic valve. It means that blood cannot flow as easily from the left ventricle to the aorta. It may also cause pressure changes in the left atrium.
• Tricuspid stenosis: The tricuspid valve opening narrows, restricting blood flow between the upper and lower parts of the right side of the heart.
• Pulmonary stenosis: The blood cannot flow as easily from the lower right chamber of the heart to the pulmonary arteries. These deliver blood to the lungs, so this condition directly affects blood flow to the lungs.
• Mitral stenosis: Mitral stenosis restricts the blood flow from the upper left part of the heart to the lower left part.

Aortic stenosis is the most common type of stenosis of the heart. It commonly affects adults over 65 but can also be the result of congenital conditions.

Learn about common heart valve disorders here.

Symptoms of aortic stenosis may not appear for 10–20 years after the condition has started to cause changes in the heart. However, if symptoms do appear, they may include:

• chest pain
• rapid heartbeat
• a fluttering sensation in the chest
• difficulty breathing
• shortness of breath
• dizziness or fainting
• difficulty walking short distances
• swelling in the ankles or feet
• difficulty sleeping or preferring to sleep sitting up

Symptoms of aortic stenosis may make it difficult for a person to carry out daily tasks. Because symptoms develop gradually, a person may not initially be vocal about them. Instead, other people may first notice a decrease in the person’s physical ability.

If an infant or child has aortic stenosis due to a condition present at birth, they may display the following symptoms:

• fatigue
• low weight
• difficulty feeding
• breathing issues

The symptoms of stenosis of the heart may be similar if a person has a different type than aortic stenosis, but they can also be similar.

The causes of stenosis of the heart will depend on its type:

• Aortic stenosis: Calcium buildup and damage to the valves can cause a narrowing over time as a person ages. However, some conditions present at birth can cause aortic stenosis in children.
• Tricuspid stenosis: Infective endocarditis and rheumatic fever are the main causes of tricuspid stenosis, but these are rare in the United States. This condition can also be due to congenital causes.
• Pulmonary stenosis: This rare condition is usually the result of a congenital condition. Tricuspid or pulmonary stenosis can results from infective endocarditis or carcinoid syndrome.
• Mitral stenosis: Most commonly, mitral stenosis is due to rheumatic fever. Other causes include:
  • calcium buildup
  • infective endocarditis
  • mitral annular calcification
  • endomyocardial fibroelastosis
  • malignant carcinoid syndrome
  • lupus
  • Whipple disease
  • Fabry disease
  • rheumatoid arthritis

Learn what the heart valves do here.

Aging is one of the biggest risk factors for stenosis of the heart. This is because as a person ages, calcium or scarring can damage the valve and restrict its opening.

If a person does not receive treatment for stenosis of the heart, it can lead to heart failure, angina, or irregular heart rhythms. It can be fatal.

To reduce the risk of complications from stenosis of the heart, people should follow a doctor’s instructions closely and be honest about any new or worsening symptoms they experience.

If a person has mild or no symptoms, maintaining a healthy lifestyle as much as possible will help reduce the risk of complications. Doctors will monitor a person regularly with testing.

The gold standard diagnosis method for cardiac stenosis is an echocardiogram. It can also help doctors determine whether a person is a suitable candidate for surgery.

Doctors may suggest exercise testing in people who are not experiencing symptoms.

If a person has calcific aortic valve disease, doctors may send them for a CT scan or a left heart catheterization if other tests have not been conclusive.

MRI scans can also help assess ventricle function and mass when the echocardiography has not been definitive.

A person with stenosis of the heart will undergo an echocardiogram to help their doctor understand which treatment options will be most helpful.

If a person does not have any symptoms, or if their symptoms are mild, doctors may simply recommend regular follow-up appointments and monitoring. This will allow them to see whether any symptoms develop or worsen with time.

Depending on the type of cardiac stenosis a person has, treatment may aim to prevent endocarditis and other complications, address new cases of rheumatic fever, and improve symptoms.

Possible treatments include:

• medications, such as high blood pressure treatments
• valve repair surgery
• valve replacement surgery

The type of heart stenosis will affect a person’s outlook. Other factors, including a person’s age and overall health and the stage of the condition, will also play a large role. A person should talk with a doctor about their outlook.

For aortic stenosis, the rate of progression can vary significantly from person to person. Regular monitoring and lifestyle strategies, such as avoiding smoking and making an effort to maintain a moderate weight, can help improve a person’s outlook. The outlook is significantly less positive in people who have symptoms.

Around 80% of people with mitral stenosis may not survive 10 years from the time their symptoms begin. In people with pulmonary hypertension due to mitral stenosis, survival time may be around 3 years. This can vary for children born with mitral stenosis, who will need regular monitoring.

The prognosis will depend on the degree of mitral stenosis and whether a person has pulmonary hypertension.

Since stenosis of the heart is usually the result of the natural aging process or conditions present at birth, prevention may not be possible.

However, a person can help prevent complications of the condition by following their doctor’s instructions closely, undergoing regular monitoring, and maintaining a healthy lifestyle.

A person should consult a doctor if they experience any new cardiac symptoms, such as:

• chest pain
• unusually fast heart rate
• difficulty breathing
• unusual dizziness or lightheadedness
• changes in exercise or activity tolerance
• swelling of the ankles or feet
• difficulty sleeping or needing to sleep sitting up

A person with a diagnosis of aortic stenosis should visit a doctor once per year for monitoring to determine whether new signs or symptoms have developed.

Stenosis of the heart includes narrowing of the heart valves and subsequent changes in blood flow and intracardiac pressure.

The most common type of stenosis of the heart valves is aortic stenosis, which commonly affects adults over age 65 as a result of the buildup of calcium and damage to the heart over time.

Stenosis of the heart valves may not cause symptoms at first.

Treatment may include surgery, as medications can treat other comorbid conditions but may not affect the valve stenosis already present. Certain lifestyle habits, such as avoiding smoking, can improve a person’s outlook.