Aortic Stenosis Overview

What is aortic valve stenosis?

Aortic stenosis is one of the most common and serious valve disease problems. Aortic stenosis is a narrowing of the aortic valve opening, and can sometimes be referred to as a failing heart valve. Aortic stenosis restricts the blood flow from the left ventricle to the aorta and may also affect the pressure in the left atrium.

Although some people have aortic stenosis because of a congenital heart defect called a bicuspid aortic valve, this condition more commonly develops during aging as calcium or scarring damages the valve and restricts the amount of blood flowing through.

Download our aortic stenosis fact sheet (PDF) | Spanish (PDF)

Does aortic stenosis always produce symptoms?

No. Many people with aortic stenosis, or AS, don't experience noticeable symptoms until the amount of restricted blood flow becomes greatly reduced.

Symptoms of aortic stenosis may include:

Chest pain
Rapid, fluttering heartbeat
Trouble breathing or feeling short of breath
Feeling dizzy or light-headed, even fainting
Difficulty walking short distances
Swollen ankles or feet
Difficulty sleeping or needing to sleep sitting up
Decline in activity level or reduced ability to do normal activities

It may be important to note the person suffering from AS may not complain of symptoms. However, if you or your family members notice a decline in routine physical activities or significant fatigue, it’s worth a visit to your health care provider to check for reduced heart function. Use our AS symptom tracker (PDF) to record your symptoms and frequency, and bring it to your next appointment to review with your doctor.

Infants and children who have aortic stenosis due to a congenital defect may exhibit symptoms such as:

Fatigue upon exertion
Failure to gain weight
Poor or inadequate feeding
Breathing problems

Watch this short video about AS symptoms.

Watch an animation of aortic valve stenosis.

How does aortic stenosis progress or cause increasing problems?

In addition to the symptoms of aortic stenosis, which may cause a patient to feel faint, weak, or lethargic, the wall of the left ventricle also may show muscular thickening because the ventricle must work harder to pump blood through the narrow valve opening into the aorta.

The thickened wall takes up more space inside the lower heart chamber that allows less room for an adequate amount of blood to be supplied to the body. This may lead to heart failure. Appropriate treatment can help reverse or slow down the progress of this disease.

Who's at risk for aortic stenosis?

Aging people

Aortic stenosis mainly affects older people as a result of scarring and calcium buildup in the valve cusp (flap or fold). Age-related AS usually begins after age 60, but often doesn’t show symptoms until ages 70 or 80.

AS in the young

The most common cause of aortic stenosis in young people is a birth defect where only two cusps grow instead of the normal three. This is called a “bicuspid aortic valve.”

Another cause may be that the valve opening doesn't grow along with the heart. This makes the heart work harder to pump blood to the restricted opening. Over the years the defective valve often becomes stiff and narrow because of calcium build-up.

bicuspid valves may restrict blood flow

What treatments are advisable for people with aortic stenosis?

If there are no symptoms or if symptoms are mild, the best course of action could be regular follow up and monitoring to see if any symptoms develop or worsen.

However, anyone with aortic stenosis should be checked with an echocardiogram to determine treatment options.

Possible treatments may include medications, valve repair or valve replacement. It’s important to discuss options with your health care team to ensure you receive the most effective treatment possible.

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