Aortic Stenosis

Basic Facts

  • The aortic valve is like the "exit door of the heart." Aortic stenosis (AS) is a narrowing of the aortic valve, which then obstructs blood flow from the left ventricle to the aorta. 
  • Typically occurs gradually over time.
  • May eventually lead to valve replacement surgery.
Aortic Valve Stenosis Treatment

The main pumping chamber of the heart, the left ventricle, has to work harder over time which can lead to congestive heart failure and other complications, especially if left untreated. Patients with severe aortic stenosis who are experiencing symptoms have a life expectancy of only 1-3 years.

There are usually no symptoms until the valve narrowing is sever, because aortic stenosis usually advances slowly over years, giving the body time to adjust. As it advances to severe, it can lead to:

  • Lightheadedness
  • Shortness of breath
  • Chest pain with exertions, resulting in decreased exercise tolerance

In the U.S., aortic stenosis most commonly develops over time due to a combination of age, high blood pressure, and atherosclerosis that damages the aortic valve. 

Smoking, diabetes, kidney disease, and high blood levels of calcium may also contribute. Sometimes it is congenital, meaning due to a defect present at birth, such as a bicuspid aortic valve. Radiation therapy used to treat cancer may be associated with valvular heart disease, if the cancer, and the radiation beam, were located near the heart.

Your healthcare provider may hear a murmur in your chest with the stethoscope. In aortic stenosis, this murmur is caused by the sound of blood "whooshing" through the narrowed valve. 

  • ECG- measures the electrical activity of the heart, regularity of heartbeats, and screens for thickening of the heart muscle (hypertrophy) and/or heart muscle damage.
  • Echocardiogram- painless, non-invasive study that uses ultrasound waves to evaluate heart structure and function, including the heart valves, in real-time.
  • Cardiac catheterization- threading a small tube up a blood vessel into the heart chambers to measure pressures across the valve.

Follow prevention tips for a heart-healthy lifestyle. Control blood pressure, as high pressure increases wear and tear on the valve over time. 

Mild to moderate aortic stenosis is followed with a "watch and wait" approach, with a visit and/or echo every 1-2 years.

For severe aortic stenosis, surgery to replace a damaged aortic valve may be necessary, especially once symptoms develop. Most replacement valves are made from animal tissue. Some may be made from metal. The type of replacement valve selected depends on the patient's age, condition, and their specific anatomy.

The damaged valve can be replaced via open heart surgery, though a much less invasive procedure called TAVR is being used more frequently now.

Patients do not need antibiotics for dental visits for aortic stenosis, unless it was due to prior endocarditis or surgery was performed on the aortic valve.