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Aortic Valve Stenosis

Overview

Having aortic valve stenosis means that the valve between your heart and the large blood vessel that carries blood to the body (aorta) has narrowed. That forces the heart to pump harder to get enough blood through the valve. As stenosis gets worse, the valve gets narrower. This can cause symptoms. Symptoms include chest pain, dizziness, fainting, or shortness of breath.

If you have mild or moderate stenosis and don't have symptoms, you may not need treatment now. Your doctor will check your heart regularly. You may need treatment if the stenosis gets worse. With severe stenosis, you may need to have the valve replaced.

  • Symptoms

    Aortic valve with stenosis

    Location of aortic valve in heart with detail of normal open and closed valve and one with stenosis

    Normal aortic valve. A normal aortic valve opens fully to let blood flow into the aorta. The aortic valve has three flaps that work like a one-way gate. When the heart pumps, the aortic valve opens to allow oxygen-rich blood to flow from the left ventricle into the aorta. When the heart rests between beats, the aortic valve closes to keep blood from flowing backward into the heart.

    Aortic valve stenosis. With aortic valve stenosis, the valve cannot open as wide as normal. Because the valve does not open as wide, the heart must work harder to pump blood through the valve.

    What are the symptoms of aortic valve stenosis?

    Aortic valve stenosis is a slow process. For many years, even decades, you may not feel any symptoms. But at some point, the valve may become so narrow that you start having symptoms. Symptoms are often brought on by exercise, when the heart has to work harder.

    As aortic valve stenosis gets worse, you may have symptoms such as:

    • Being short of breath, especially when you're active.
    • Chest pain or pressure (angina). You may have a heavy, tight feeling in your chest.
    • Feeling dizzy or faint.
    • Feeling tired.
  • Causes

    What causes aortic valve stenosis?

    Aortic valve stenosis can be caused by calcium buildup on the valve. It can also be caused by a heart defect that you were born with, such as a bicuspid aortic valve. It may also be caused by rheumatic fever, which can damage the valve.

  • Diagnosis

    How is aortic valve stenosis diagnosed?

    A physical exam and review of your medical history are important first steps in diagnosing aortic valve stenosis. If you have stenosis but no symptoms, your doctor will likely find the condition during a routine exam or a checkup for another health problem.

    Your doctor will check your blood pressure and pulse and will listen for abnormal sounds, such as a heart murmur. A distinctive heart murmur is usually the first clue that leads a doctor to suspect aortic valve stenosis. You may have tests, including an electrocardiogram.

    An echocardiogram can confirm the diagnosis. It can also show how severe your aortic valve stenosis is and see how well the left ventricle of your heart is working.

  • Treatment

    How is aortic valve stenosis treated?

    Your treatment will likely depend on how much the valve is narrowed and if you have symptoms. If you have mild or moderate aortic valve stenosis and you don't have symptoms, your doctor will see you regularly to check your heart.

    You may take medicine that lowers blood pressure or cholesterol. Your doctor will likely recommend a heart-healthy lifestyle. This lifestyle means that you:

    • Don't smoke.
    • Eat heart-healthy foods.
    • Be active. Ask your doctor what level and type of exercise is safe for you.
    • Stay at a healthy weight. Lose weight if you need to.
    • Manage other health problems.

    If you have severe stenosis, you may choose to have the valve replaced. Valve replacement can be done with an open-heart surgery or a minimally invasive procedure. Valve replacement can help you feel better and live longer.

    Some people may have another procedure called valvuloplasty to widen the valve and help relieve symptoms.

  • Course

    What happens when you have aortic valve stenosis?

    When you have aortic valve stenosis, the valve gets narrower over time. Your heart has to work harder to pump blood through the aortic valve. Symptoms include chest pain, dizziness, and shortness of breath. Stenosis can lead to heart failure. You may choose to have the valve replaced if the stenosis gets worse.

  • When to Call

    Aortic valve stenosis: When to call

    Call 911 anytime you think you may need emergency care. For example, call if:

    • You passed out (lost consciousness).
    • You have symptoms of a heart attack. These may include:
      • Chest pain or pressure, or a strange feeling in the chest.
      • Sweating.
      • Shortness of breath.
      • Nausea or vomiting.
      • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
      • Lightheadedness or sudden weakness.
      • A fast or irregular heartbeat.

    After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.

    Call your doctor now or seek immediate medical care if:

    • You have new symptoms or your symptoms get worse.
    • You have new or increased shortness of breath.
    • You are dizzy or lightheaded, or you feel like you may faint.
    • You have sudden weight gain, such as more than 2 to 3 pounds in a day or 5 pounds in a week. (Your doctor may suggest a different range of weight gain.)
    • You have new or increased swelling in your legs, ankles, or feet.
    • You are suddenly so tired or weak that you cannot do your usual activities.

    Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

  • Self-Care

    Caring for yourself when you have aortic valve stenosis

    You can live a full and active life by doing things that help keep your heart and body healthy. Here's how.

    • Have a heart-healthy lifestyle.
      • If you smoke, try to quit. Medicines and counseling can help you quit for good. Avoid secondhand smoke too.
      • Eat heart-healthy foods. These foods include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit things that aren't so good for your heart, like sodium, alcohol, and sugar.
      • Be active but don't start an exercise program on your own without talking with your doctor first. You may need some tests to see what kind and level of exercise is safe for you. Try for at least 30 minutes of activity on most days of the week. If activity is not likely to cause health problems, you probably don't have limits on the type or level of activity that you can do. If your condition is severe, your doctor will likely advise you to avoid strenuous activity.
      • Stay at a healthy weight. Lose weight if you need to.
      • Manage other health problems. These include diabetes, high blood pressure, and high cholesterol. If you think you may have a problem with alcohol or drug use, talk to your doctor.
    • Take care of yourself.
      • Call your doctor right away if you have new symptoms or symptoms that get worse.
      • Go to your checkup appointments. And get the tests you need to assess your heart, such as echocardiograms.
      • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
      • Practice good dental hygiene, and have regular checkups. Good dental health is especially important. That's because bacteria can spread from teeth and gums to the heart valves.
      • Get a flu vaccine every year. And get a pneumococcal vaccine shot. If you've had one before, ask your doctor if you need another dose.
      • Talk with your doctor if you have concerns about sex and your heart. Your doctor can help you know if or when it's okay for you to have sex.

    Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.