Patient education: Aortic stenosis (The Basics)

What is aortic stenosis? — Aortic stenosis is a condition in which the aortic valve doesn't open fully (figure 1). The aortic valve is one of the 4 heart valves. The heart valves keep blood flowing in only 1 direction. When the heart valves work normally, they open all the way to let blood flow through them.

Blood flows from a chamber of the heart called the left ventricle, through the aortic valve, into a large blood vessel called the aorta (figure 1). The aorta carries blood to the rest of the body.

In aortic stenosis, the aortic valve gets stuck and does not open fully. This makes the valve opening narrow. When this happens:

●Not as much blood can flow out of the heart to the rest of the body.

●The heart has to work much harder than usual to pump blood to the rest of the body. Over time, this can cause heart problems.

Aortic stenosis usually happens in adults. But some people are born with aortic stenosis.

What are the symptoms of aortic stenosis? — Early on, most people have no symptoms. They usually find out they have aortic stenosis after their doctor or nurse hears a heart murmur on a routine exam. A heart murmur is an extra sound in the heartbeat that doctors or nurses hear when they listen to the heart with a stethoscope.

When people do have symptoms, they can have:

●Shortness of breath

●Dizziness or fainting

●Chest pain

These symptoms usually happen with physical activity. Let your doctor know if you have any of these symptoms.

Is there a test for aortic stenosis? — Yes. To check for aortic stenosis and see how severe it is, your doctor might order an echocardiogram (or "echo"). This test uses sound waves to create a picture of your heart as it beats. It shows the size of the heart chambers, how well the heart is pumping, and how well the heart valves are working (figure 2). If you have aortic stenosis, your doctor might repeat this test over time to see if your condition changes.

Your doctor might order a test called an electrocardiogram (ECG). This test measures the electrical activity in your heart (figure 3).

To get more information about your heart, your doctor might order a test called cardiac catheterization, or "cardiac cath." For this, the doctor puts a thin tube into a blood vessel in your leg or arm. Then they move the tube up to your heart. When the tube is in your heart or blood vessels, they will take measurements. The doctor might also put a dye that shows up on an X-ray into the tube. This can show if any of the arteries in your heart are narrowed or blocked. This part of the test is called "coronary angiography."

Some people with aortic stenosis will also have a chest X-ray. A chest X-ray can show the size and shape of your heart. It can also show changes from water in your lungs caused by aortic stenosis or other diseases.

How is aortic stenosis treated? — It depends on your symptoms and how severe your aortic stenosis is. If your aortic stenosis is not severe and you have no symptoms, your doctor will see you regularly. This way they will know if your aortic stenosis gets worse or you start to have symptoms.

If your aortic stenosis is severe and you have symptoms, you will likely need treatment. Treatment can include:

●A procedure to put in a new valve – This can be done with surgery or without surgery:

•During surgery, the doctor will remove your narrowed valve and replace it with a valve that opens normally. This new valve can be made from metal or from tissue from an animal or another person. Your doctor will talk with you about the benefits and downsides of each option.

•A procedure to put in a new aortic valve without surgery is called "transcatheter aortic valve implantation" (TAVI) or "transcatheter aortic valve replacement" (TAVR).

●A procedure to open the aortic valve – For this procedure, a doctor inflates a balloon in the narrowed aortic valve to try to open it. This procedure is used in children and young adults, because it is helpful in these people. This procedure is usually less helpful in older adults.

●Medicines – There are no medicines to treat the aortic valve stenosis itself. Your doctor might prescribe medicines to treat your symptoms. They will also make sure your blood pressure and cholesterol level are under control.

Can I play sports? — You and your doctor should discuss the level of physical activity that is right for you. If your aortic stenosis is mild, you can probably play sports. But if your aortic stenosis is more serious or you have symptoms, your doctor might recommend that you limit your physical activity.

What if I want to get pregnant? — If you want to get pregnant, talk with your doctor or nurse. Depending on your aortic stenosis and symptoms, they might recommend treating your aortic stenosis before you get pregnant.

More on this topic

Patient education: Heart murmurs (The Basics)
Patient education: Syncope (fainting) (The Basics)
Patient education: ECG and stress test (The Basics)
Patient education: Echocardiogram (The Basics)
Patient education: Cardiac catheterization (The Basics)
Patient education: Prosthetic valves (The Basics)