Know the basics
What is aortic stenosis?
Aortic stenosis, also known as aortic valve stenosis, is a disorder in which the opening of the aortic valve in the heart does not open fully, which decreases blood flow from the heart. A valve is like a doorway, and the aortic valve is one of four valves controlling blood flow inside the heart. A normal aortic valve has three flaps (leaflets). The heart sends oxygen rich blood to the body through this valve. In aortic stenosis, the heart is forced to work harder to pump blood through the smaller opening of the aortic valve. Over time, the extra workload will cause the heart to become bigger and weaker.
How common is aortic stenosis?
Aortic stenosis is a common condition. It occurs about three times more often in men than in women. It is more common in older ages. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
Know the symptoms
What are the symptoms of aortic stenosis?
Signs and symptoms of aortic stenosis may not appear in the early stages. When the valve becomes smaller, blood flow will decrease and lead to symptoms such as:
- Chest pain that spreads to the arms and throat;
- Coughing, sometimes with blood;
- Feeling tired, fainting with exercise;
- Shortness of breath due to heart failure of the left-sided of the heart;
- Breathing problems during exercise may progress to problems at rest, or waking up at night unable to breathe;
- Fast heartbeat.
There may be some signs or symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- Recently had heart valve surgery;
- Bleeding from surgery wound;
- Chest pain, shortness of breath, palpitations;
- Sudden weakness in the limbs;
- Vision problems;
- High fever.
Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
Know the causes
What causes aortic stenosis?
Aortic stenosis is caused by the narrowing of the aortic valve. There are many factors that can cause the narrowing of the aortic valve. These factors may include:
- Congenital heart defect: some children are born with an aortic valve that is not fully formed. Usually a normal aortic valve has 3 flaps (tricuspid). A defected aortic valve may have 1 flap (unicuspid), 2 flaps (bicusbid) or 4 flaps (quadricuspid). This defect may not cause any problems until the child becomes an adult.
- Calcium build-up on the valve: The aortic valve can collect calcium deposits from the blood. Overtime with age, the calcium build-up would cause the aortic valve to harden and stiffen, which leads to narrowing of the valve. This is common in men over 65 years old and in women over 75 years old.
- Rheumatic fever: One of the complications of rheumatic fever is causing scar tissue to develop on the aortic valve. This scar tissue can narrow the valve and make it easier for calcium deposits to build-up. Aortic stenosis would occur later in life.
Know the risk factors
What increases my risk for aortic stenosis?
There are many risk factors for aortic stenosis, such as:
- Aortic valve defect: This defect would make you more at risk. This defect is usually known when you are born. Please let your doctor know if you have this congenital heart defect.
- Age: As you get older, you have a higher chance of having calcium build-up on the aortic valve.
- History of having rheumatic fever: Rheumatic fever can cause your aortic valve to harden, which makes you more at risk for aortic stenosis.
- Health conditions: Researches have found that there is a link between chronic kidney disease and diabetes type 2 to aortic stenosis. Please let your doctor know if you have this condition.
- High blood pressure;
- High cholesterol;
- And smoking.
Understand the diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is aortic stenosis diagnosed?
To give a proper diagnosis, your doctor may perform the following tests:
- Medical history and physical examination;
- The doctor may hear a heart murmur (an extra or unusual sound of blood flow through the valve during the heartbeat).
- Echocardiogram (ECG);
- Exercise stress testing;
- Magnetic Resonance Image (MRI) of the heart;
- Transesophageal echocardiogram (TEE).
How is aortic stenosis treated?
People without symptoms and with mild stenosis may not need treatment but should be monitored on a periodic basis by their doctor. For patient with symptoms, the following treatment may be needed:
- Drug treatment: there are no drug that can help stop the aortic stenosis. But your doctor may prescribe medications to help with your symptoms. These drugs would help manage fluid retention in the heart, lower your heart rate, and lower your blood pressure. This would help slow the progression of the stenosis.
When the symptoms become more severe, the only option is to fix the valve. These procedures may include:
- Balloon valvuloplasty: This procedure is a less invasive alternative. Usually the doctor would insert a balloon connected to a soft thin tube (catheter). The balloon would then be placed at the aortic valve to be inflated. This inflation would widen the valve and increase blood flow. This would usually give temporarily relief and the narrowing would return. This option is usually best for patients who want to avoid surgery.
- Surgical valvuloplasty: This treatment option is rare but common in infants who have a valve defect that cause the flaps to fuse together. During this surgery the doctor would repair the valve by separating the valves and increase blood flow.
- Aortic valve replacement: This usually the primary treatment for severe aortic stenosis. The damaged aortic valve would be replaced by either a mechanic valve or tissue valve. The risk for having a mechanic valve is having blood clots. You may need anticoagulants such as warfarin. The tissue valve is made from a cow, pig or deceased human donor. The risk of the tissue valve is that the aortic stenosis may return over time.
- Transcatheter aortic valve replacement: This is usually the most common treatment option for aortic stenosis. During this procedure, a prosthetic valve (made from your own tissue) would be inserted by a balloon catheter. The tissue used to make the prosthetic valve usually is taken from the femoral artery from your leg or the left ventricle. This procedure is usually reserved for patients who have severe aortic stenosis with complications and need to avoid surgery.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage aortic stenosis?
The following lifestyles and home remedies might help you cope with aortic stenosis:
- Ask your doctor if you can exercise and determine a suitable exercise routine.
- Stop smoking.
- Start a low-salt diet and lose weight if you have congestive heart failure.
- Call your doctor if, after you get a new valve, you have chest pain, shortness of breath, palpitations or rapid heart-beat, fainting, sudden weakness in an arm or leg, eyesight problems, fever, or blood from the surgery site.
- Treat any other diseases that may lead to aortic stenosis such as rheumatic fever or high blood pressure.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: May 30, 2016 | Last Modified: January 4, 2017