Narrowing of the aortic valve is called aortic stenosis. It can happen for a variety of reasons, including congenital defects, rheumatic fever and prior radiation therapy. But by far the most common reason is age-related calcification and degeneration of the valve.
Symptoms of Aortic Stenosis
Most often, there are not any symptoms when aortic stenosis is mild or moderate in severity. When the valve becomes more severely narrowed however, patients may start to notice symptoms. Patient who have symptoms associated with severe aortic stenosis are at high risk for potentially life-threatening problems, and should be considered for treatment.
When present, early symptoms include:
- Shortness of breath on exertion
- Decreased stamina and reduced activity
In more advanced cases of aortic stenosis, the aortic valve gets tighter, and symptoms include:
- Dizziness or passing out
- Chest pain/angina
- Heart failure
Aortic Stenosis Tests
There are a few tests that can detect aortic stenosis. The first one is simply a doctor listening to your heart through a stethoscope. Aortic stenosis usually causes a heart murmur, or an abnormal noise that the heart makes, when it pumps blood. If your doctor hears a heart murmur with her stethoscope, that can be a first sign of aortic stenosis.
Your doctor can also do an ultrasound of the heart. This is called echocardiography, and it’s the primary test used to diagnose the severity of aortic stenosis. This test is noninvasive and uses sound waves to make an image of your heart.
Heart catheterization, an invasive test that measures the severity of aortic stenosis, is needed for all patients who will undergo valve surgery.
Aortic Stenosis Treatment
The traditional treatment for severe, symptomatic aortic stenosis is surgical valve replacement. This entails open-heart surgery, removing the aortic valve and replacing it with either a tissue valve or mechanical valve.
For patients who are a higher risk for surgery-related complications due to their age or other medical conditions, transcatheter aortic valve replacement, or TAVR, has become the treatment of choice. This entails the placement of a new valve inside the patient’s own valve, and it can usually be done through a small incision in the patient’s groin. Patients usually only need light sedation for TAVR, but breathe on their own and do not require a breathing machine or chest incision.