Aortic stenosis

Pending medical review by Dr. Ravinder Singh Rao. [Remove this note once approved.]

Aortic stenosis means the aortic valve has become narrow and stiff, so it does not open fully. The heart has to work harder to push blood out to the body.

What causes it

• Wear and calcium build-up on the valve with age, the most common cause in older adults
• A valve with two flaps instead of three (a bicuspid valve), present from birth
• Rheumatic heart disease, after rheumatic fever earlier in life

Signs to watch for

• Breathlessness when walking, climbing stairs or lying flat
• Chest pain, pressure or tightness during activity
• Feeling dizzy or light-headed, or fainting
• Tiredness, and doing less than you used to
• A fast or fluttering heartbeat
• Swollen ankles or feet

These signs often come on slowly, so people put them down to age. Tell your doctor about any of them, especially if they are new or getting worse.

How it is diagnosed

• Listening to the heart: a murmur is often the first clue.
• Echocardiogram (ultrasound of the heart): the main test. It shows how narrow the valve is and how well the heart is pumping.
• ECG to check the heart’s rhythm.
• CT scan to measure the valve and blood vessels if TAVR is being considered.
• Angiogram, sometimes, to check the heart’s own arteries.

Why timing matters

Medicines can ease some symptoms, but they cannot open a narrowed valve. Severe aortic stenosis tends to get worse over time, and once symptoms start it can worsen quickly. If you have been told your valve is narrow, ask a heart valve team when it should be treated.

Watch Dr. Rao explain aortic stenosis and how it is diagnosed (YouTube).

Next: What is TAVR?