Aortic Stenosis

At Memorial Hermann Health System, our award-winning affiliated specialists diagnose, treat and manage a wide range of cardiovascular conditions. We are committed to providing patient-centered, comprehensive care to deliver the best possible outcomes.

Aortic stenosis is a life-threatening condition often associated with a heart murmur. Early detection is very important, because aortic stenosis doesn’t always show symptoms until the disease is advanced. If you are experiencing cardiovascular symptoms like chest pain, shortness of breath or swelling in your legs and feet, you should seek medical attention. The earlier you are diagnosed, the better chance you have to effectively manage the disease.

What Is Aortic Stenosis?

Aortic stenosis occurs when the heart’s aortic valve becomes too narrow. This is a common but serious heart-valve disease that is often caused by the aging process. Occasionally, aortic stenosis is caused by a birth defect, rheumatic fever or radiation therapy.

The aortic valve is the main heart valve through which all of the blood flow must pass on its way out of the heart to the rest of body. When the valve is narrowed, it does not fully open. This restricts and slows the amount of blood that flows from the heart to the other organs.

Diagnosing and treating aortic stenosis is crucial, because the disease can cause many complications, including:

• Bleeding
• Blood clots
• Heart failure
• Arrhythmia (irregular heartbeat)
• Stroke

A heart murmur is often one of the first signs of aortic stenosis.

What is a Heart Murmur?

Four valves control the flow of blood through the chambers of the heart and out to the rest of the body. Heartbeat sounds are the sounds of these valves closing.

A heart murmur is an abnormal or extra sound, in addition to the normal heartbeat, that is caused by turbulent blood flow created when an aortic valve does not close tightly. When the valve does not fully close, blood leaks backwards and causes an extra heartbeat sound.

Aortic stenosis can be either congenital (present at birth) or acquired (developed later in life). There are three main causes of aortic stenosis:

Calcium Build-Up in the Aortic Valve

In elderly patients, severe aorta stenosis is often caused by the build-up of calcium (mineral deposits) on the aortic valve's leaflets. Over time the leaflets become stiff, reducing their ability to fully open and close. When the leaflets don't fully open, your heart must work harder to push blood through the narrowed aortic valve to the rest of your body. Eventually, your heart gets weaker, increasing the risk of heart failure (a condition in which your heart cannot supply enough blood to your body)..

Congenital Heart Defect

Children can be born with a bicuspid aortic valve. This means that there are only two cusps (instead of three) in the valve. This congenital (present at birth) defect may go undetected until adulthood.

Rheumatic Fever

This condition is a complication from strep throat. It is not common. Rheumatic fever can cause scar tissue to form in the aortic valve which may lead to aortic stenosis.

Sometimes symptoms do not appear until you have had aortic stenosis for many years. Patients with symptoms may experience the following:

• Breathlessness with activity
• Pain that increases with exercise, and is relieved with rest
• Fainting, weakness or dizziness with activity
• Chest pain that can be crushing, squeezing, pressure or tightness
• Pain under the chest bone that may move to other areas
• Palpitations (sensation of feeling the heart beat)

There are several risk factors associated with aortic stenosis:

• Older age
• Congenital heart defect
• History of radiation to the chest area
• History of heart infection
• Diabetes
• High cholesterol
• High blood pressure

Taking some preventive steps can help reduce your risk of developing aortic stenosis:

Maintain Good Cardiovascular Health.

Keep blood pressure, cholesterol and weight in the healthy range.

Maintain Good Oral Health.

Some evidence suggests a connection between gum disease and heart disease.

Prevent Rheumatic Fever.

Seek medical attention when you have a sore throat. Strep throat can be treated with antibiotics so that it does not develop into rheumatic fever.

Aortic stenosis can be diagnosed with a physical examination and diagnostic testing. Hearing a heart murmur with a stethoscope can be a sign of a problem with the aortic valve.

If your doctor suspects aortic stenosis, they may recommend any of the following tests:

• Chest X-ray
• Angiogram (cardiac catheterization)
• Echocardiogram
• Electrocardiogram (ECG or EKG)
• Cardiac CT scan
• Cardiac MRI

Your doctor will recommend a specific treatment plan based on the severity of your condition. With mild symptoms or no symptoms, your doctor may suggest healthy lifestyle changes, medication and/or regular follow-up appointments to monitor your condition.

More severe cases of aortic stenosis may require a treatment procedure:

Valvuloplasty

Valvuloplasty is a minimally invasive procedure. During valvuloplasty, a balloon-tipped tube is threaded through a blood vessel and into the faulty valve. The balloon is inflated to widen the opening of the valve, then deflated and removed along with the tube.

Minimally Invasive Valve Repair/Least Invasive Valve Surgery (LIV)

Surgeons affiliated with Memorial Hermann are world renowned for pioneering aortic surgery techniques. In minimally invasive mitral valve repair/least invasive valve surgery, the surgeon makes a small incision on the right side of the chest, below the breast fold, and repairs or replaces the faulty valve under direct vision.

Transcatheter Aortic Valve Replacement (TAVR)

TAVR is an innovative, minimally invasive treatment for patients with severe aortic stenosis who are at intermediate or high risk for open-heart surgery. The surgeon uses catheters in blood vessels to replace the aortic valve with a specially designed artificial valve. The new heart valve is inserted via a small incision in a major artery. Once in place, the new valve expands, pushing the diseased valve aside to increase blood flow through the heart.

Our affiliated specialists are highly trained in diagnosing, treating and managing aortic stenosis. To learn more, visit Find a Doctor to schedule an appointment with an affiliated Memorial Hermann Heart & Vascular physician.