Aortic Valve Stenosis

The aorta is the main artery of the body. Oxygenated blood leaves the heart by way of the aorta and is carried to all parts of the body. The left ventricle is the chamber of the heart that pumps blood into the aorta through the aortic valve. Aortic valve stenosis occurs when this valve doesn’t open all the way, preventing blood from flowing properly. A narrow aortic valve limits the circulation of oxygenated blood to the rest of your body.

What Causes Aortic Valve Stenosis?

The aortic valve opens and closes every time your heart beats. This continuous action occurs every second of your life. Genetics and certain health conditions may prevent the valve from completing its proper functions.

Genetics

Aortic valve stenosis may be present at birth. The opening of the valve is made up of three flaps, or “leaflets,” that when functioning properly, fit together tightly when closed. Some children are born without all three leaflets, with the leaflets not separated properly, or leaflets too thick to completely open or close.

Rheumatic Fever

Rheumatic fever is a condition that may affect the brain, joints, heart, and skin. It can occur in adults and children who have, or have had, strep throat. Strep throat is a contagious condition caused by the streptococcal bacteria. Rheumatic fever is also one of the most common causes of heart valve problems.

Calcification of the Valves

Calcium is an important mineral needed for strong bones. However, the mineral may present problems in your heart if it deposits in the aortic valve. Calcium deposits usually affect the flaps (known as leaflets) in a valve. Calcium deposits can prevent the aortic valve from properly opening and closing.

The valve’s leaflets may also allow blood to leak back into the left ventricle after it enters the aorta. This is called valvular insufficiency or regurgitation.

Who Is at Risk for Aortic Valve Stenosis?

There are several risk factors that may affect you or someone in your family.

Sex

Men have a higher risk of aortic valve stenosis than women. The condition most often occurs in men between the ages of 30 and 60.

Genetics

Children born with malformed valve leaflets instead of three will have problems with normal blood flow through the aorta.

Disease

Having rheumatic fever can produce significant problems with the valve leaflets. Scar tissue from the disease can make them hard or cause them to fuse. Rheumatic fever damages the heart tissue, valves, and coronary arteries.

What Are the Symptoms of Aortic Valve Stenosis?

This condition generally produces symptoms only once it progresses. In the beginning, you may not notice symptoms.

The following are symptoms for severe aortic valve stenosis: 

  • chest pain as the heart strains to pump enough blood through the compromised valve
  • feeling tired after exertion (exercise, moving)
  • feeling short of breath, especially after exertion
  • heart palpitations (abnormal heartbeats)
  • developing a heart murmur (an abnormal sound, such as a “swooshing,” heard in the heart as it beats)

Infants and children may have different symptoms, or may not appear to display any symptoms at all. If they do display symptoms, they might include an inability to put on weight or not feeding very well. They might also become fatigued very easily. In severe cases, an infant may have major breathing difficulties that develop within weeks of birth. There is the potential for mild cases to become worse in children as they get older.

How Is Aortic Valve Stenosis Diagnosed?

After reporting your symptoms to your general doctor, you may be referred to a cardiologist (heart specialist). Your cardiologist will check your physical condition with a thorough examination. This includes listening to your heart for any abnormal sounds. You may need imaging tests to show what is going on inside your heart.

The following are some of the imaging tests used:

  • MRI (magnetic resonance imaging) scan (creates highly detailed images of internal body structures)
  • CT (computed tomography) scan (creates three-dimensional images)
  • chest X-ray
  • echocardiogram (provides video images of your heart)
  • cardiac catheterization (a procedure that uses dye to highlight any blockages in the heart)

How Is Aortic Valve Stenosis Treated?

There are no specific medications to fix aortic valve stenosis because the condition is irreversible once it occurs. Your doctor can prescribe medication to treat the problems caused by the condition, or the health issues that produced the condition in the first place.

Medications

Although medication cannot cure aortic valve stenosis, drugs can be used to manage symptoms or decrease the burden on your heart. Rheumatic fever would require antibiotics to keep any infection from advancing and causing heart damage. Blood pressure medication such as beta blockers or calcium channel blockers can help lower your blood pressure. Medications to manage your heart’s rhythm (anti-arrhythmics) or blood thinners (such as Coumadin) may be necessary.

Surgery

Your doctor may recommend surgery to repair or replace the damaged valve. The surgery to repair the valve is called valvuloplasty. This procedure can be performed cardioscopically. A long, thin catheter with a tiny balloon at the end is inserted into a vein in your groin or arm. The surgeon guides the tube into your heart and inflates the balloon. Once the valve is opened, the balloon and catheter are removed. The procedure is minimally invasion and recovery time is shortened.

Your surgeon may decide your damaged valve must be replaced. This would require open heart surgery. Your surgeon may use a mechanical valve or a valve from a cow or pig. Sometimes valves from human cadavers are used. Open heart surgery requires a much longer period for recovery.

Long-Term Outlook

Your health may improve dramatically once your condition is properly treated. Surgical treatments for aortic valve stenosis have high rates of success. However, much depends on how long you have lived with the condition, the extent of any damage to your heart, and any complications that may arise from your condition.

How Can Aortic Valve Stenosis Be Prevented?

If your aortic valve stenosis is not a congenital defect (that is, you were not born with the condition), there are steps you can take to ease any burden on your heart. Eat a healthy diet low in saturated fat, exercise regularly, maintain a healthy weight, and abstain from smoking. Also, report any abnormal health issues to your physician. You may prevent rheumatic fever by visiting your doctor for any severe sore throat conditions. Good dental hygiene is also important as dental infections can travel through the blood stream and damage the heart valves and muscles.