What is aortic valve stenosis?

Aortic valve stenosis is a narrowing of the aortic valve . The aortic valve allows blood to flow from the heart's lower left chamber (ventricle) into the aorta and to the body. Stenosis prevents the valve from opening properly, forcing the heart to work harder to pump blood through the valve. This causes pressure to build up in the left ventricle and thickens the heart muscle.

Your heart can make up for aortic valve stenosis and the extra pressure for a long time. But at some point, it won't be able to keep up the extra effort of pumping blood through the narrowed valve. This can lead to heart failure.

What causes aortic valve stenosis?

Problems that can cause aortic valve stenosis include:

• Calcium buildup on the aortic valve. As you age, calcium can build up on the valve, making it hard and thick. This buildup happens over time, so symptoms usually don't appear until after age 65.
• A heart defect you were born with (congenital).
• Rheumatic fever or endocarditis. These infections can damage the valve.

What are the symptoms?

Aortic valve stenosis is a slow process. For many years, even decades, you will not feel any symptoms. But at some point, the valve will likely become so narrow (often one-fourth of its normal size) that you start having problems. Symptoms are often brought on by exercise, when the heart has to work harder.

As aortic valve stenosis gets worse, you may have symptoms such as:

• Chest pain or pressure (angina). You may have a heavy, tight feeling in your chest.
• Feeling dizzy or faint.
• Feeling tired and being short of breath.
• A feeling that your heart is pounding, racing, or beating unevenly (palpitations).

If you start to notice any of these symptoms, let your doctor know right away. If you have symptoms, you need treatment. By the time you have symptoms, your condition probably is serious. If you have symptoms, you also have a high risk of sudden death.

How is aortic valve stenosis diagnosed?

Most people find out they have it when their doctor hears a heart murmur during a regular physical exam. To be sure of the diagnosis, your doctor may want you to have an echocardiogram, which can show moving pictures of your heart. You may have other tests to help your doctor judge how well your heart is working.

How is it treated?

If you don't have symptoms, your doctor will see you regularly to check your heart. You probably will not have surgery. Unless you have symptoms, or tests show that the heart's pumping action is getting weak, surgery is likely to be more risky than the disease.

If you have symptoms, you probably need surgery right away. Surgery to replace the aortic valve is the best treatment for most people. View a slideshow on aortic valve replacement surgery . Some young people or people who cannot have open-heart surgery may have another procedure called balloon valvuloplasty to enlarge the valve opening.

If you don't have surgery after you start having symptoms, you may die suddenly or develop heart failure. Surgery can help you have a more normal life span.