Aortic valve stenosis

Alternative names

Aortic stenosis

Definition

The aorta is the large artery that originates in the left ventricle (lower chamber) of the heart. Aortic stenosis is the narrowing or obstruction of the heart's aortic valve, which prevents it from opening properly and blocks the flow of blood from the left ventricle to the aorta.

Causes, incidence, and risk factors

Aortic stenosis is caused by many disorders. One common cause is rheumatic fever, a complication of untreated strep throat. Other causes include calcification of the valve and congenital abnormalities (disorders present at birth). There may be a history of other valve diseases, coronary artery disease, or heart murmur.

Aortic stenosis occurs in approximately 5 out of every 10,000 people. It is more common among men. Symptoms often do not appear until middle age or older.

Symptoms

• fainting or weakness with activity
  
• breathlessness with activity
  
• sensation of feeling the heart beat (palpitations)
  
• chest pain, angina-type
  o under the sternum, may radiate
  o crushing, squeezing, pressure, tightness
  o increased with exercise, relieved with rest
  

Note: Aortic stenosis may show no symptoms until late in the course of the disease.

Additional symptoms that may be associated with this disease:

• dizziness
  

Signs and tests

Examination shows a palpable chest thrill or heave (vibration or movement felt by holding the hand over the heart). There is almost always a heart murmur, click, or other abnormal sound on auscultation (examination of the chest with a stethoscope). There may be a faint pulse or changes in the quality of the pulse in the neck (the change in pulse is known as pulsus parvus et tardus). Blood pressure may be low.

Aortic stenosis and/or enlargement of the left ventricle may be revealed on:

• left Cardiac catheterization
  
• echocardiogram (sonogram test of the heart)
  
• Doppler ultrasonography
  
• transesophageal echocardiogram (TEE)
  
• Chest x-ray may show dilation of the aorta.