Overview

What is the aortic valve? What is aortic valve stenosis?
The heart has
four
chambers
. In the lower left chamber (left ventricle), the
aortic
valve
works like a one-way gate. When the heart pumps, the aortic valve
opens to let oxygen-rich blood flow from the left ventricle into a large blood
vessel called the
aorta. Blood then flows through the aorta to the rest
of the body.
Aortic valve stenosis
means that this valve has
narrowed, and it can't open all the way. The heart has to work harder to pump
blood through the smaller opening. The heart can do this for many years, but
over time it gets worn out. It can no longer send out as much blood as your
body needs. If you don't get treatment,
heart failure may develop.
What causes aortic valve stenosis?
Problems that can cause aortic valve stenosis include:
- Calcium buildup on the aortic valve. As you
age, calcium can build up on the valve, making it hard and thick. This buildup
happens over time, so symptoms usually don't appear until after age 65. Many of
the same things that increase your risk for hardening of the arteries (atherosclerosis) make you more likely to have aortic
valve stenosis. They include smoking, being male, or having
high cholesterol,
high blood pressure, or
diabetes.
- A heart defect you were born
with (congenital). Some babies are born with an aortic valve that has only two
flaps instead of the normal three. This is called a bicuspid valve, and it
makes a smaller opening for blood to flow through. In this case, symptoms
usually start around age 40.
- Rheumatic fever
or
endocarditis. These infections can damage the valve.
What are the symptoms?
Aortic valve stenosis is a slow process. For many years, even
decades, you will 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.
As aortic valve stenosis gets worse, you may have symptoms such
as:
- Chest pain (angina). You
may have a heavy, tight feeling in your chest. Chest pain is often brought on
by exercise, when the heart has to work harder.
- Feeling dizzy or
faint, often after you have been active.
- Feeling tired and being
short of breath when you are active.
- A fast, slow, or uneven
heartbeat (arrhythmia).
- A feeling that your heart is
pounding, racing, or beating unevenly (palpitations).
If you start to notice any of these symptoms, let your doctor
know right away. If you have symptoms, you need treatment. By the time you have
symptoms, your condition probably is serious. If you have symptoms, you also
have a high risk of sudden death.1
How is aortic valve stenosis diagnosed?
Most people find out they have it when their doctor hears a heart
murmur during a regular physical examination. To be sure of the diagnosis, your
doctor may want you to have an
echocardiogram, which can show moving pictures of your
heart. You may have other tests to help your doctor judge how well your heart
is working.
How is it treated?
If symptoms develop, you will probably need surgery right away.
Surgery to replace the aortic valve is the best treatment for most people. View
a slide
show on aortic valve replacement surgery
. Young people or people who
cannot have open-heart surgery may have another procedure called balloon
valvuloplasty to enlarge the valve opening.
If you do not have surgery after you start having symptoms, you
may die suddenly or develop heart failure. Most people who have symptoms of
severe aortic valve stenosis die within 2 to 5 years if they do not have valve
replacement surgery.2 Surgery can help you have a more
normal life span.
If you don't have symptoms, your doctor will see you regularly to
check your heart. You probably will not have surgery. Until you have symptoms,
surgery is likely to be more risky than the disease.3
Medicines do not cure the disease, but they can treat some
problems that aortic valve stenosis can cause. You might need to take medicines
that help control irregular heart rhythms or blood thinners (anticoagulants) to prevent blood clots.