Aortic valve stenosis â or aortic stenosis â occurs when the heart's aortic valve narrows. This narrowing prevents the valve from opening fully, which reduces or blocks blood flow from your heart into the main artery to your body (aorta) and onward to the rest of your body.
When the blood flow through the aortic valve is reduced or blocked, your heart needs to work harder to pump blood to your body. Eventually, this extra work limits the amount of blood it can pump, and this can cause symptoms as well as possibly weaken your heart muscle.
Your treatment depends on the severity of your condition. You may need surgery to repair or replace the valve. Left untreated, aortic valve stenosis can lead to serious heart problems.
Aortic valve disease care at Mayo Clinic
Aortic valve stenosis ranges from mild to severe. Aortic valve stenosis signs and symptoms generally develop when narrowing of the valve is severe. Some people with aortic valve stenosis may not experience symptoms for many years. Signs and symptoms of aortic valve stenosis may include:
The heart-weakening effects of aortic valve stenosis may lead to heart failure. Heart failure signs and symptoms include fatigue, shortness of breath, and swollen ankles and feet.
If you have a heart murmur, your doctor may recommend that you visit a cardiologist. If you develop any symptoms that may suggest aortic valve stenosis, see your doctor.
Your heart has four valves that keep blood flowing in the correct direction. These valves include the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Each valve has flaps (cusps or leaflets) that open and close once during each heartbeat. Sometimes, the valves don't open or close properly, disrupting the blood flow through your heart and potentially impairing the ability to pump blood to your body.
In aortic valve stenosis, the aortic valve between the lower left heart chamber (left ventricle) and the main artery that delivers blood from the heart to the body (aorta) is narrowed (stenosis).
When the aortic valve is narrowed, the left ventricle has to work harder to pump a sufficient amount of blood into the aorta and onward to the rest of your body. This can cause the left ventricle to thicken and enlarge. Eventually the extra work of the heart can weaken the left ventricle and your heart overall, and it can ultimately lead to heart failure and other problems.
Aortic valve stenosis can occur due to many causes, including:
Congenital heart defect. The aortic valve consists of three tightly fitting, triangular-shaped flaps of tissue called cusps. Some children are born with an aortic valve that has only two (bicuspid) cusps instead of three. People may also be born with one (unicuspid) or four (quadricuspid) cusps, but these are rare.
This defect may not cause any problems until adulthood, at which time the valve may begin to narrow or leak and may need to be repaired or replaced.
Having a congenitally abnormal aortic valve requires regular evaluation by a doctor to watch for signs of valve problems. In most cases, doctors don't know why a heart valve fails to develop properly, so it isn't something you could have prevented.
Calcium buildup on the valve. With age, heart valves may accumulate deposits of calcium (aortic valve calcification). Calcium is a mineral found in your blood. As blood repeatedly flows over the aortic valve, deposits of calcium can build up on the valve's cusps. These calcium deposits aren't linked to taking calcium tablets or drinking calcium-fortified drinks.
These deposits may never cause any problems. However, in some people â particularly those with a congenitally abnormal aortic valve, such as a bicuspid aortic valve â calcium deposits result in stiffening of the cusps of the valve. This stiffening narrows the aortic valve and can occur at a younger age.
However, aortic valve stenosis that is related to increasing age and the buildup of calcium deposits on the aortic valve is most common in older people. It usually doesn't cause symptoms until ages 70 or 80.
Rheumatic fever. A complication of strep throat infection, rheumatic fever may result in scar tissue forming on the aortic valve. Scar tissue alone can narrow the aortic valve and lead to aortic valve stenosis. Scar tissue can also create a rough surface on which calcium deposits can collect, contributing to aortic valve stenosis later in life.
Rheumatic fever may damage more than one heart valve, and in more than one way. A damaged heart valve may not open fully or close fully â or both. While rheumatic fever is rare in the United States, some older adults had rheumatic fever as children.
To diagnose aortic valve stenosis, your doctor may review your signs and symptoms, discuss your medical history, and conduct a physical examination. Your doctor may listen to your heart with a stethoscope to determine if you have a heart murmur that may indicate an aortic valve condition. A doctor trained in heart disease (cardiologist) may evaluate you.
Your doctor may order several tests to diagnose your condition and determine the cause and severity of your condition. Tests may include:
Echocardiogram. This test uses sound waves to produce video images of your heart in motion. During this test, specialists hold a wandlike device (transducer) on your chest. Doctors may use this test to evaluate your heart chambers, the aortic valve and the blood flow through your heart. A doctor generally uses this test to diagnose your condition if he or she suspects you have a heart valve condition.
This test can help doctors closely look at the condition of the aortic valve, and the cause and severity of your condition. It can also help doctors determine if you have additional heart valve conditions.
Doctors may conduct another type of echocardiogram called a transesophageal echocardiogram to get a closer look at the aortic valve. In this test, a small transducer attached to the end of a tube is inserted down the tube leading from your mouth to your stomach (esophagus).
Cardiac catheterization. This test isn't often used to diagnose aortic valve disease, but it may be used if other tests aren't able to diagnose the condition or to determine its severity.
In this procedure, your doctor threads a thin tube (catheter) through a blood vessel in your arm or groin and guides it to an artery in your heart.
Doctors may inject a dye through the catheter, which helps your arteries become visible on an X-ray (coronary angiogram). This provides your doctor with a detailed picture of your heart arteries and how your heart functions. It can also measure the pressure inside your heart chambers.
Aortic valve stenosis can cause complications, including:
Some possible ways to prevent aortic valve stenosis include:
Once you know that you have aortic valve stenosis, your doctor may recommend that you limit strenuous activity to avoid overworking your heart.
You'll have regular follow-up appointments with your doctor to monitor your condition. You'll need to continue taking all your medications as prescribed.
Your doctor may suggest you incorporate several heart-healthy lifestyle changes into your life, including:
For women with aortic valve stenosis, it's important to talk with your doctor before you become pregnant. Your doctor can discuss with you which medications you can safely take, and whether you may need a procedure to treat your valve condition prior to pregnancy.
You'll likely require close monitoring by your doctor during pregnancy. Doctors may recommend that women with severe valve stenosis avoid pregnancy to avoid the risk of complications.
Risk factors of aortic valve stenosis include: