Heart valve disorders
Aortic valve stenosis
What is aortic valve stenosis?
Aortic valve stenosis
Your aortic valve lies between your aorta and your left ventricle. It opens when your ventricle contracts so that re-oxygenated blood can flow into your aorta and out to the rest of your body.
When your ventricle relaxes again and refills with blood from your lungs, the leaflets on your aortic valve close, and this prevents the re-oxygenated blood in your aorta from flowing back into your ventricle again.
For more information about how your heart works, take a look at Your heart: The basics.
If you have aortic valve stenosis (also commonly known as aortic stenosis), that means that the aortic valve, which is the outlet from your left ventricle into your aorta, has narrowed and blood flow is somewhat blocked (“stenosis” means “narrowing”).
This usually happens because your aortic valve’s leaflets (also known as flaps or cusps) have become stiff and thickened.
Occasionally, the stenosis also develops above or below the level of the valve rather than only involving the valve itself.
Aortic valve stenosis is one of the most common and serious heart valve disorders. Many people with aortic valve stenosis also develop aortic valve regurgitation; the valve doesn’t open well, and it also doesn’t close well, and these two disorders are often seen together.
Because aortic valve stenosis can put a strain on your left ventricle it may lead to left heart failure.
If your stenosis is severe, you may need to have surgery to repair or replace your aortic valve.
What causes aortic valve stenosis?
The most common cause of aortic valve stenosis is atherosclerosis. With long-standing atherosclerosis, your aortic valve may collect calcium deposits that thicken it, narrow the outlet, and make it inflexible. This process is frequently a result of normal aging.
The risk of calcium build-up on the aortic valve can be increased by diseases like rheumatic heart disease, which cause scarring that can make plaque accumulation more likely.
Another significant risk factor is a bicuspid aortic valve. A bicuspid valve has two leaflets, or cusps, instead of the normal three. It is a congenital condition.
About 1% of people are born with bicuspid aortic valves and a small proportion of those people will go on to develop valve problems later in life.
Occasionally, aortic valve stenosis can be present at birth, in which case it usually occurs with other problematic conditions.
Common causes of aortic valve stenosis include:
- Calcium build-up on the aortic valve, usually caused by atherosclerosis. This can happen with normal aging
- A bicuspid aortic valve: This is a relatively common congenital heart problem that increases your risk of developing aortic valve problems later in life
- Rheumatic heart disease
What are the symptoms of aortic valve stenosis?
If you have mild aortic valve stenosis you may not really notice it, but if you have moderate or serious disease you may experience quite severe symptoms.
Here are some common symptoms of aortic valve stenosis.
- Shortness of breath when you exercise or lie down
- Dizziness or fainting
- Chest discomfort or pain
If you experience these symptoms you should immediately seek medical assistance.
Aortic stenosis can lead to left heart failure, and if that happens your symptoms may also include tiredness and swollen feet and ankles.
How is aortic valve stenosis treated?
Your doctor will determine the best course of treatment for your aortic valve stenosis based on the severity of your symptoms.
If you have mild stenosis, you may not need any treatment at all.
However, if your doctor is concerned and wants to make sure your condition doesn’t worsen, he or she may recommend one or more of the following treatments:
- Medications to help control any other cardiovascular problems that may be worsening your condition
- Diuretics to reduce your fluid load
- Lifestyle changes to help get high blood pressure and atherosclerosis under control
- Surgery: In severe cases, you may need surgery to repair or replace your aortic valve
What are the aims of treatment?
The aims of treatment for people with mild aortic valve stenosis are to stabilize your condition and prevent it from worsening. If your condition is more severe, and you need surgery, the aim is to restore normal valve function.