Overview, Causes, & Risk Factors
Aortic stenosis is a narrowing of the opening of the aortic valve.
The aortic valve is a flap-like opening located between the left side of the
heart and the aorta. The aorta is the main artery carrying blood from the
heart.
What is going on in the body?
The heart is divided into two halves, right and left. Each side has a pumping
chamber, called a ventricle. The left ventricle receives blood from the lungs.
During a heartbeat, the left heart chamber squeezes, generating enough pressure
to open the aortic valve. Blood from the left side is then pumped into the
aorta and out into the body. When aortic stenosis has occurred, the opening of
the valve is narrower than normal. This reduces the amount of blood flow to the
body.
What are the causes and risks of the condition?
The causes of aortic stenosis include:
calcium deposits that harden, or calcify, the valve
congenital heart disease from heart defects present
at birth
scarring of the valve from rheumatic heart disease
Symptoms & Signs
What are the signs and symptoms of the condition?
Common symptoms of aortic stenosis include:
coughing at
night
fainting, especially
with physical activity
fatigue
shortness of breath
that worsens at night or with exertion
visual impairments
The coronary arteries, which carry oxygen to heart
muscles, may be deprived of blood. That can cause heart pains called stable
angina or unstable angina. This type of pain has been described
as a tightness, squeezing, or pressing sensation in the middle of the chest.
The pain commonly extends into the left shoulder and down the arm.
The severity of symptoms is not always related to the severity of the disease.
In fact, people sometimes die suddenly from aortic stenosis without having had
symptoms.
Diagnosis & Tests
How is the condition diagnosed?
Diagnosis of aortic stenosis begins with a history and physical
exam. The healthcare provider also may do one or more of these tests:
cardiac catheterization
chest
X-ray
echocardiogram with or without color Doppler studies
electrocardiogram (EKG)
Prevention & Expectations
What can be done to prevent the condition?
In many cases, nothing can prevent aortic stenosis. Proper treatment of
rheumatic fever with antibiotics can prevent damage to the aortic
valve.
What are the long-term effects of the condition?
As the aortic valve slowly narrows, it deprives body organs of
blood. Serious long-term effects may include:
congestive heart failure, a condition in which the
weakened heart is unable to pump enough blood throughout the body
coronary heart disease
enlargement of the left ventricle, which cuts down the output of the heart
still more
pulmonary edema, or
congestion in the lungs
sudden death
What are the risks to others?
Aortic stenosis is not contagious, and poses no risk to
others.
Treatment & Monitoring
What are the treatments for the condition?
A goal of treatment is to allow the heart to get more blood into general
circulation. Various medicines can help improve overall blood supply to the
body and the heart. They can also help reduce the person's symptoms.
In some cases, surgery is recommended to correct the
aortic stenosis. Balloon valvuloplasty is a technique that lowers the pressure
across the valve by slightly enlarging the opening. This is usually done when
someone is not stable enough for corrective surgery. More often, heart valve surgery is performed to
correct the problem with the aortic valve.
What are the side effects of the treatments?
Medicines used to treat aortic stenosis can cause a variety of side
effects. Surgery can cause bleeding, infection, or allergic reaction to anesthesia.
What happens after treatment for the condition?
Successful replacement of the valve restores normal blood flow. The long-term
outcome is usually very good. Artificial valves wear out over a period of
years. Their function is monitored, and the valves are replaced as necessary.
Some artificial valves require that the person take:
antibiotics before and after surgeries or dental work to avoid serious
heart infections
blood-thinning drugs to avoid blood clots, such as deep venous
thrombosis
How is the condition monitored?
An individual with aortic stenosis will have regular visits with
the healthcare provider. The provider may order regular
electrocardiograms and echocardiograms to detect any signs
of deterioration. Any new or worsening symptoms should be reported to the
provider.