Aortic stenosis

Aortic stenosis is a heart condition affecting your aortic heart valve. It can sometimes lead to problems like heart failure.

Your aortic valve is like a one-way door, letting blood out of your heart to your aorta. Your aorta is the artery that carries blood to the rest of your body.

In aortic stenosis, the aortic valve opening is narrowed. This makes it harder for your heart to pump blood through to your aorta.

Aortic stenosis is more common in older people.

Symptoms of aortic stenosis often come on with exercise or physical activity. They include:

• tiredness
• feeling short of breath
• chest pain
• fainting or feeling faint (light-headedness)

People with aortic stenosis may also have symptoms of heart failure.

Some people with aortic stenosis don't have any symptoms.

The most common cause of aortic stenosis is the aortic valve becoming hard or scarred. This can happen as you get older.

Some things can increase your risk of aortic stenosis. These include:

• smoking
• having high blood pressure
• having high cholesterol
• having chronic kidney disease

You may be born with an aortic valve that is shaped differently. This can cause you to get aortic stenosis earlier in life.

A less common cause of aortic stenosis is rheumatic heart disease. Rheumatic heart disease can develop after rheumatic fever, if your heart valves get damaged.

Chest pain can be a symptom of a heart attack. Call triple zero (000) immediately and ask for an ambulance if your chest pain is severe, getting worse or has lasted for 10 minutes.

See your doctor straight away if you have symptoms that come on when you are active, including:

• shortness of breath
• feeling faint or fainting
• chest pain

Your doctor will ask you about your symptoms and examine you. They might hear a heart murmur when they listen to your heart.

Depending on what they find, you might be asked to have tests such as:

• an ECG (electrocardiogram)
• a chest x-ray
• an echocardiogram, which is an ultrasound scan of your heart

An ECG can show if the left side of your heart is enlarged. This can happen due to the effort of pumping blood through a narrow valve.

A chest x-ray can show signs of heart failure.

An echocardiogram shows how well your heart is pumping. It also shows whether any of your heart valves are narrowed or not working properly.

Your doctor may refer you to a cardiologist (a heart specialist) for more tests and treatment.

Treatment for aortic stenosis depends on several factors. These include:

• your age
• your general health
• how severe your symptoms are
• if your symptoms are getting worse quickly
• your heart function
• other test results

If your aortic stenosis is not severe or not causing symptoms, your doctor may suggest that you have regular check-ups to monitor your condition.

Some people with aortic stenosis need an operation or procedure to replace their aortic valve. This is called aortic valve replacement.

Another procedure is sometimes done where your aortic valve is opened with a tiny balloon. This doesn't work as well as replacing the valve. It's usually only done as a temporary treatment in some people.

Your doctor may also recommend medicines to lower your blood pressure and cholesterol.

Treatment for children with aortic stenosis

Children with aortic stenosis can sometimes get their aortic valve repaired. However, if the valve is very abnormal it's better to replace it with a new one.

Using a balloon to stretch the valve can help for a while. But over time the valve can become narrow again. This means that another operation might need to be done.

Untreated aortic stenosis can put a strain on your heart. This can cause complications such as:

• irregular heart rhythms
• heart failure

If you've had a valve replacement, you may need to take antibiotics before some dental procedures. This is to prevent endocarditis (an infection of your heart valves).

Aortic stenosis related to rheumatic heart disease can be prevented by:

• seeing your doctor whenever you're sick with a sore throat or skin infection and getting treatment quickly to prevent rheumatic fever
• getting treatment with antibiotics if you've had rheumatic fever

It may also help to address lifestyle factors for aortic stenosis, including:

• stopping smoking
• treating high blood pressure
• treating high cholesterol

The Heart Foundation offers support and information for people with heart conditions, including information on how your heart works and heart valve disease.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.