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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 will likely become so narrow (often one-fourth of its normal size) that you start having problems. 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:

    • Chest pain or pressure (angina). You may have a heavy, tight feeling in your chest.
    • Feeling dizzy or faint.
    • Feeling tired and being short of breath.
    • A feeling that your heart is pounding, racing, or beating unevenly (palpitations).
  • Causes

    What causes aortic valve stenosis?

    Aortic valve stenosis usually is caused by aging and calcium buildup on the valve. It can also be caused by a heart defect that you were born with (congenital) or by infections that damage the valve, such as rheumatic fever or endocarditis.

  • 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.

    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

    What is the treatment for aortic valve stenosis?

    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 probably will not have surgery until your stenosis is severe or until the benefits of surgery outweigh the risks.

    If you have severe stenosis, you probably need a valve replacement. Valve replacement can be done with an open-heart surgery or a minimally invasive procedure. Some people may have another procedure called balloon valvuloplasty to enlarge the valve opening and help relieve symptoms.

    If you have severe stenosis but don't have your valve replaced, you have a high risk of dying suddenly or developing heart failure. Replacing your valve can help you have a more normal life span and improve your quality of life.

  • Course

    What happens when you have aortic valve stenosis?

    When you have aortic valve stenosis, your heart has to work harder to pump blood through the aortic valve. Over time, the valve gets narrower. This can cause chest pain, dizziness, fainting, or shortness of breath. You may need 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 develop new symptoms of aortic valve stenosis, such as chest pain, dizziness, or shortness of breath.
    • 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 increased swelling in your legs, ankles, or feet.

    Watch closely for changes in your health, and be sure to contact your doctor if:

    • You have trouble making healthy lifestyle changes.
    • You want more information about healthy lifestyle changes.
  • Self-Care

    Caring for yourself when you have aortic valve stenosis

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

    • Make healthy lifestyle changes.
      • If you smoke, try to quit. Medicines and counseling can help you quit for good. Avoid secondhand smoke too.
      • Your doctor will also recommend that you follow a heart-healthy diet and limit how much sodium you eat.
      • Be active, but you might need to avoid strenuous exercise. Physical activity is good for your overall health. But the type of exercise that is right for you depends on how severe your aortic valve stenosis is. If you have mild stenosis, you won't need to restrict your level or type of physical exercise. But if you have severe stenosis, you should avoid strenuous activities such as weight lifting or running. Talk with your doctor about what kinds of exercise are safe for you.
      • If you need to lose weight, try to reach and stay at a healthy weight.
    • Take care of yourself.
      • See 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.
      • Manage other health problems, such as high blood pressure, diabetes, and high cholesterol.
      • 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. He or she 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.