Understanding Aortic Stenosis

Aortic stenosis (AS) is a condition in which the aortic valve, which pumps blood from the heart to the rest of the body, becomes narrowed. (“Stenosis” means narrowing.) It is most commonly caused by calcium buildup on the valve. This buildup leads to stiffening and narrowing of the aortic valve, which restricts blood flow out of the heart.¹

Aortic stenosis affects millions of older adults worldwide. It is one of the most common and serious heart valve diseases. AS is sometimes called a failing heart valve.¹

How does aortic stenosis affect the heart and body?

The heart’s aortic valve is essential for circulating blood throughout the body. When the valve becomes narrowed, the heart must work harder to pump blood through the smaller opening.¹

Over time, this increased effort can lead to the thickening of the heart muscle (left ventricular hypertrophy). Eventually, it can lead to heart failure or sudden death if left untreated.^1,2

Symptoms of aortic stenosis can include:¹

• Chest pain
• Dizziness or lightheadedness
• Difficulty walking short distances
• Fatigue
• Rapid heartbeat
• Shortness of breath

Often, people do not know they have AS and dismiss their symptoms as just a sign of aging. If you have unexplained fatigue or are no longer able to do everyday activities, talk with your doctor about getting your heart checked.¹

Who does aortic stenosis affect?

Aortic stenosis mostly affects older adults, typically those over 65. In the United States, more than 12 percent of older people have AS. Because of the country’s aging population, this number is expected to increase.¹

But AS can also occur in younger people. The most common cause of AS in younger people is a birth defect called bicuspid aortic valve. This happens when there are 2 valve flaps instead of 3, which can restrict blood flow.¹

How is aortic stenosis diagnosed?

Early diagnosis of AS is critical. AS is diagnosed through a combination of medical history, physical exam, and a specialized test called an echocardiogram. An echocardiogram, or “echo,” is a type of ultrasound that provides detailed images of the aortic valve’s structure and function.^1,3

If necessary, doctors may use other tests as well, such as:^1,3

• Chest X-ray
• Electrocardiogram
• Exercise or pharmacological stress tests
• Cardiac computerized tomography (CT) scan
• Cardiac magnetic resonance imaging (MRI) scan
• Transesophageal echocardiogram

How is aortic stenosis treated?

Treatment for aortic stenosis depends on the severity of the condition and the presence of symptoms. For mild AS, doctors usually recommend monitoring symptoms and maintaining a healthy lifestyle. Medicines that lower your blood pressure may also be helpful.^1,3

If your symptoms are more severe, you may need an aortic valve replacement. This procedure can be performed via open heart surgery or with a minimally invasive procedure known as transcatheter aortic valve replacement (TAVR).^1,4

TAVR is especially beneficial for older adults or those with other health conditions that make open-heart surgery too risky. During TAVR, the surgeon inserts a new valve via a catheter, usually through the femoral artery in the groin, and positions it within the existing valve. A TAVR procedure means less time in the hospital and a quicker recovery.⁴

Aortic valve replacement has been shown to improve life expectancy and quality of life. Most people experience a significant reduction in symptoms and a return to normal activities after surgery.¹

What is the prognosis of aortic stenosis?

The prognosis for AS depends on the severity of the condition and the timeliness of treatment. Without treatment, severe AS has a poor prognosis, with a high risk of heart failure and sudden death. However, with appropriate treatment, most people go on to live healthy, active lives.¹