The aorta is the main artery leaving the heart. When blood leaves the heart, it flows from the lower chamber — the left ventricle — through the aortic valve and into the aorta. Patients with aortic stenosis have an aortic valve that does not open fully. This condition restricts blood flow.
As the aortic valve narrows, pressure increases inside the left ventricle. This pressure causes it to thicken, decreasing blood flow and possibly leading to chest pain. As the pressure continues to rise, blood may back up into the lungs, causing shortness of breath. Severe forms of aortic stenosis prevent enough blood from reaching the brain and rest of the body. This can cause lightheadedness and fainting.
Aortic stenosis may be present from birth (congenital), or it may develop later in life (acquired). Children with aortic stenosis may have other congenital conditions. In adults, aortic stenosis occurs most commonly in those who have had rheumatic fever, a condition that may develop after strep throat or scarlet fever. Valve problems do not develop for five to 10 years after rheumatic fever occurs. Rheumatic fever is increasingly rare in the United States.
Only rarely do other factors lead to aortic stenosis in adults. These include calcium deposits forming around the aortic valve, radiation treatment to the chest, and some medications. Aortic stenosis is not common. It occurs more often in men than in women.
People with aortic stenosis may have no symptoms at all until late in the course of the disease. Symptoms can include:
- Breathlessness with activity
- Chest pain
- Crushing, squeezing, pressure, tightness
- Pain that increases with exercise and is relieved with rest
- Pain under the chest bone, perhaps moving to other areas
- Fainting, weakness or dizziness with activity
- Sensation of feeling the heart beat (palpitations)
- In infants and children, symptoms can include becoming fatigued with exertion more easily than others or serious breathing problems that develop within days or weeks of birth.
A health care provider should be consulted if symptoms of aortic stenosis occur in adults or children.
In mild cases, treatment may be limited to being monitored by a health care provider. Patients with aortic stenosis are often told not to play competitive sports, even if they have no symptoms. Patients should stop smoking and be treated for high cholesterol. People with aortic stenosis should see a cardiologist every three to six months.
Surgery to repair or replace the valve is the preferred treatment for adults or children who develop symptoms. For high-risk patients, a less-invasive procedure called balloon valvuloplasty may be done in adults or children.
Complications of aortic stenosis can include arrhythmias, endocarditis, left-sided heart failure or left ventricular hypertrophy (enlargement) caused by the extra work of pushing blood through the narrowed valve.
Texas Health is committed to providing quality care to heart and vascular patients throughout North Texas and beyond. While various technologies and services are discussed here, not all of our hospitals offer every treatment and diagnostic technology highlighted. Call 1-877-THR-WELL to learn more about heart and vascular services at a Texas Health hospital near you.