Aortic Stenosis

What Is Aortic Stenosis? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Abigail Libers
By Medically Reviewed by 
Reviewed:
Medically Reviewed
Aortic stenosis, also known as aortic valve stenosis, is a heart condition in which the aortic valve of the heart narrows, preventing it from opening fully. This cuts off or reduces blood flow from the heart to the aorta (the main artery of the body) and the rest of the body, causing the heart to work harder than usual.

As a result, less blood can be pumped to the body, which can lead to serious health problems.

Signs and Symptoms of Aortic Stenosis

Symptoms of aortic stenosis include:


  • Chest pain
  • Breathlessness or trouble breathing
  • Fainting, dizziness, or feeling lightheaded
  • Rapid, fluttering heartbeat
  • Swollen feet or ankles
  • Becoming tired quickly during normal activities, including walking
  • Trouble sleeping

Not everyone with aortic stenosis has noticeable symptoms. In fact, many people don’t experience symptoms until the amount of restricted blood flow is significant. If you do experience symptoms, see your doctor, who can check the severity of the aortic stenosis and for reduced heart function.

Symptoms of aortic stenosis in infants and children due to a congenital defect include:

  • Inability to gain weight
  • Fatigue during normal activities
  • Difficulty feeding
  • Trouble breathing

Causes and Risk Factors of Aortic Stenosis

There are many causes of aortic stenosis. These include:

  • Calcium on the Valve In older adults, narrowing of the aortic valve with restricted opening can occur when scarring or calcium damages the valve.

  • Congenital Problems In young people, the most common cause of aortic stenosis is bicuspid aortic valve, a congenital defect in which only two valve cusps (flaps or folds) develop instead of the usual three.
  • Rheumatic Fever Rheumatic fever, a complication of strep throat, can make scar tissue form on the aortic valve, causing it to narrow.

Risk Factors

Risk factors for aortic stenosis include:

  • Aging
  • Congenital heart disease
  • Infections that affect the heart
  • Diabetes
  • High cholesterol
  • High blood pressure
  • Chronic kidney disease
  • Radiation therapy to the chest

How Is Aortic Stenosis Diagnosed?

First, your doctor will ask you about your symptoms, review your medical history, and perform a physical exam, including listening to your heart with a stethoscope.

Next, your healthcare provider may order tests to make a diagnosis of aortic stenosis. These tests may include:

  • Echocardiogram This imaging test uses sound waves to make a picture of your heart. This picture shows your doctor how well your heart valves are working.
  • Electrocardiogram (ECG or EKG) This test measures electrical activity in the heart.
  • Chest X-Ray This can show your doctor whether your heart and aorta are enlarged and if you have calcium buildup on your aortic valve.
  • Exercise Test Checking your physical fitness can help doctors determine if you have symptoms of aortic valve disease.
  • Cardiac Computerized Tomography (CT) Scan A series of X-rays are taken to create detailed images of your heart.
  • Cardiac Magnetic Resonance Imaging (MRI) Magnetic fields and radio waves create detailed pictures of your heart that can help determine the severity of your condition.

Prognosis of Aortic Stenosis

Aortic stenosis may be mild and not cause any symptoms, or it can lead to serious heart problems.

Appropriate treatment often has excellent results.

Duration of Aortic Stenosis

Aortic stenosis due to aging usually begins after you turn 60; however, you may not experience symptoms until age 70 or 80.


As such, you may experience aortic stenosis for decades without realizing it.

Treatment and Medication Options for Aortic Stenosis

Treatment for aortic stenosis varies based on the severity of your condition, whether you’re symptomatic, and if your condition is worsening.

If your symptoms are mild, your healthcare provider may keep an eye on your condition with regular appointments. They may also recommend heart-healthy lifestyle changes and certain medications.

If your aortic stenosis is severe, treatment options may include replacing the aortic valve.

Medication Options

Your doctor may prescribe drugs to alleviate your symptoms and help prevent further problems, especially if your condition is mild or you can’t have surgery.


These medications may include:

  • Anti-arrhythmic medications, to keep your heart rhythm normal when arrhythmias (irregular heartbeats) develop
  • Anticoagulants or blood thinners, to reduce the risk of blood clots
  • Beta-blockers, to decrease the heart’s workload and reduce palpitations
  • ACE Inhibitors, to decrease blood pressure when hypertension is present
  • Diuretics, to reduce the amount of fluid in the tissues and the bloodstream
  • Vasodilators, to open and relax the blood vessels

Surgery

Surgical options to treat aortic valve stenosis include:

Aortic Valve Replacement Aortic valve replacement is frequently needed to treat aortic valve stenosis. The surgery involves removing the damaged valve and replacing it with a mechanical valve or a valve made from cow, pig, or human heart tissue. If you have a mechanical valve, you must take blood-thinning medications for the rest of your life to prevent blood clots.

Transcatheter Aortic Valve Replacement Transcatheter aortic valve replacement (TAVR) is a less invasive procedure in which doctors use a catheter to replace an aortic valve that has narrowed. TAVR may be the best option for you if you’re at high risk of complications from surgical aortic valve replacement.

Aortic Valve Repair In rare cases, surgeons repair an aortic valve to treat aortic stenosis.

Balloon Valvuloplasty To treat aortic valve stenosis in infants and children, doctors may insert a catheter with a balloon on the tip into an artery in your arm or groin and guide it to the aortic valve. They then inflate the balloon, which expands the opening of the narrowed valve. For adults, this procedure is typically only performed on those who are too sick to manage a more invasive surgery like aortic valve replacement.

Prevention of Aortic Stenosis

Nothing can be done to prevent congenital aortic stenosis,

but there are steps you can take to avoid developing the condition in the future.

Aortic stenosis may be prevented by:

  • Keeping Your Heart Healthy High blood pressure, obesity, and high cholesterol levels may be linked to aortic stenosis, so stay healthy by keeping your blood pressure, weight, and cholesterol level in check.
  • Maintaining Good Oral Hygiene Infected gums can cause inflammation of heart tissue that can aggravate aortic stenosis.
  • Avoiding Rheumatic Fever See your doctor if you have a sore throat. Left untreated, strep throat can develop into rheumatic fever, which can cause aortic stenosis.

Complications of Aortic Stenosis

Initially, aortic stenosis may be mild with no symptoms.

However, over time, the following complications can occur:

Research and Statistics: Who Has Aortic Stenosis?

Aortic stenosis is most commonly diagnosed in older adults, but some babies are born with it.

Roughly 2 percent of adults over age 65 have the disease.

The condition is more common in men than in women.

BIPOC Communities and Aortic Stenosis

Aortic stenosis may be underdiagnosed in BIPOC (Black, Indigenous, and People of Color) populations. According to a 2020 study, patients from underrepresented racial and ethnic groups — in the study data, this included Black, Hispanic, and Asian patients — are diagnosed with aortic stenosis less frequently than white patients even though they tend to have more of the traditional risk factors (such as chronic kidney disease, hypertension, obesity, and diabetes).

This may be because the diagnosis is frequently missed in these patients.

Additionally, the study found that individuals from underrepresented racial and ethnic groups are less likely than white patients to have aortic valve replacement surgery; however, they are more likely to experience post-surgery complications including bleeding, worsening heart failure, and readmission to the hospital. Patients from underrepresented groups with severe aortic stenosis are also at a higher risk for morbidity and mortality compared with white patients.

Related Conditions and Causes of Aortic Stenosis

Many people with aortic stenosis also have other cardiac conditions, including:

Resources We Love

Mayo Clinic

The Mayo Clinic is a nonprofit organization that specializes in clinical practice, education, and research. Its website offers information about the symptoms, causes, risk factors, complications, prevention, diagnosis, and treatment of aortic stenosis.

American Heart Association (AHA)

The AHA is the country’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. Its website offers information about the symptoms, risk factors, and treatment of aortic stenosis.

MedlinePlus

MedlinePlus is a service of the National Library of Medicine (NLM), the world’s largest medical library, which is part of the National Institutes of Health (NIH). It offers information about the causes, symptoms, diagnosis, and treatment of aortic stenosis.

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