Aortic Valve Stenosis: Causes, Symptoms & Treatment

Aortic valve stenosis, a form of valvular heart disease, occurs when the aortic valve fails to open properly, decreasing the flow of blood from the heart. If you have been diagnosed with aortic valve stenosis, your SSM Health physician will monitor your condition closely. Together you will determine the best option for treatment.

What Causes Aortic Valve Stenosis?

The aorta is the primary artery carrying blood away from the heart, to be used throughout the body. When blood is pumped through the heart, it leaves through the aortic valve.

Sometimes, the aortic valve is unable to open fully, decreasing the flow of blood from the heart. This causes the heart to work harder when pumping blood to the body. To compensate, the heart walls thicken and narrow the heart valve. Over time, this can limit the amount of blood the heart can pump and weaken the heart itself. Aortic stenosis is not very common and occurs more often in men than in women.

There are three main causes of aortic valve stenosis:

  • Congenital heart defect
  • Calcium deposits
  • Rheumatic fever

Signs & Symptoms of Aortic Valve Stenosis

People with aortic stenosis may show no symptoms until the disease has progressed significantly. Aortic valve stenosis symptoms can include:

  • Abnormal heart sound (heart murmur)
  • Shortness of breath with activity
  • Chest pain (angina)
  • Crushing tightness
  • Pain increase with exercise, and relief with rest
  • Fainting, weakness or dizziness with activity
  • Noticeable rapid, strong or irregular heartbeat (palpitation)

Diagnosing Aortic Valve Stenosis

Diagnosing aortic valve stenosis requires your primary care physician to review your health history and perform a physical exam. Abnormal heart sounds, like a murmur or a click, heard through a stethoscope may indicate a valve problem.

Your doctor may order the following tests to diagnose aortic stenosis:

  • Chest X-ray
  • Doppler echocardiography
  • ECG
  • Exercise stress testing
  • Left cardiac catheterization
  • MRI of the heart
  • Transesophageal echocardiogram (TEE)

If left untreated, aortic valve stenosis can lead to life-threatening heart problems, including:

  • Chest pain (angina)
  • Fainting (syncope)
  • Heart failure
  • Irregular heart rhythms (arrhythmias)
  • Cardiac arrest

Because of the risk of complications, it is critical that you receive prompt treatment to ensure the best possible outcomes. If you’re experiencing any unusual symptoms, schedule an appointment with your primary care provider to discuss your concerns.

Treating Aortic Valve Stenosis

At SSM Health our expert physicians use the latest technologies so you can be confident you are receiving the best possible care Our team will perform a complete evaluation and then discuss your options for treatment.

If you have mild or no symptoms, your doctor may simply monitor your condition without treatment. In that case you may be advised to limit strenuous activity and to quit smoking if you currently are.

While there are no medications to treat aortic stenosis specifically, your doctor may prescribe medication to treat the symptoms, including diuretics, nitrates, and beta-blockers.

Aortic Valve Replacement

In most cases, your doctor will recommend surgery to repair or replace the valve. With aortic valve replacement, a surgeon removes the restricted aortic valve and replaces it with either a mechanical or tissue valve. This procedure is proven effective to improve quality of life.

Mechanical valves are made from a durable metal. However, they carry the risk of blood clots forming in nearby areas. If you opt for a mechanical valve you will be put on anticoagulant medication for life to prevent this from happening.

Tissue valves are another option. These are sourced from organ donors or compatible animals. They are just as effective as mechanical valves, but eventually require replacement. It is occasionally possible to use a patient’s own pulmonary valve through a grafting procedure.

In rare cases, surgical repair may be possible. This is most common in infants where the valve is blocked because of tissue growth instead of calcium buildup.

Transcatheter Aortic Valve Replacement (TAVR)

The cardiac experts at SSM Health Saint Louis University Hospital and SSM Health St. Mary's Hospital - Madison offer a minimally invasive procedure to treat aortic valve stenosis. Transcatheter aortic valve replacement (TAVR) is an effective treatment if you’re not a good candidate for open heart surgery.

TAVR is performed by inserting a new valve through a catheter, inserted through the arteries in the leg. The new valve is guided into the old, diseased valve and opened up, “replacing” the narrowed valve with a new, instantly functional, tissue prosthetic valve.

This procedure has proven to not only improve quality of life, but significantly prolong one’s life following the procedure.

SSM Health heart and vascular care surgeons consistently perform highly successful aortic valve procedures using traditional and minimally invasive approaches. These minimally invasive procedures greatly reduce pain, postoperative bleeding and recuperation time. If you've already been diagnosed with a heart valve disease and would like a second opinion from a Saint Louis University Hospital doctor on your treatment options, including information about minimally invasive surgery options, request a second opinion online.

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