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Advances in Aortic Stenosis

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It's Not Old Age, It's Aortic Stenosis

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Older man out of breath while running

Slowing down is a normal part of aging—as they get older, many people have decreased levels of activity. But when this occurs along with other symptoms like fatigue, swollen ankles and feet, or weakness, it can be a sign of a more serious problem.

Aortic stenosis is a heart condition in which the heart’s aortic valve narrows and blood can’t flow properly out of the heart to the rest of your body. In many cases, it affects older people, but aortic stenosis isn’t a natural part of aging, and the sooner you get a diagnosis, the lower your risk of serious complications like heart failure, stroke, blood clots, and death.

Understanding Aortic Stenosis

Your heart has four different valves that open and close to direct the flow of blood through your heart. The aortic valve is located between the large, lower left heart chamber and a large artery–the aorta–that carries blood out of your heart and into your body.

When aortic stenosis occurs, the aortic valve narrows, and your heart must work harder to pump the same amount of blood to your body. This extra work puts serious strain on your heart and can eventually weaken the heart muscle itself, reducing the heart’s ability to pump blood effectively. Since blood can’t flow normally with aortic stenosis, it’s common for people living with the condition to tire easily, preventing them from being as active as they once were. Because of this, people might chalk it up to just another effect of getting older–but that’s not the case.

Aortic stenosis may result from:

  • Calcium buildup on the aortic valve. We all need calcium to live, but over time, calcium may build up on the aortic valve. In many cases, this never causes problems. But for some, these calcium deposits cause the aortic valve to stiffen, preventing it from opening and closing normally.
  • Congenital heart defects. In some cases, children are born with heart defects like a misshapen aortic valve. This may not cause any problems until adulthood, when the valve may need to be surgically repaired or replaced.
  • Rheumatic fever. Rheumatic fever is a complication of a strep throat infection. Over time, rheumatic fever causes scar tissue to build up on the aortic valve. This scar tissue narrows the valve and helps create a better surface for calcium deposits to build upon.

Common symptoms of aortic stenosis include:

  • Chest pain
  • Difficulty sleeping, or needing to sleep sitting up
  • Difficulty walking, even for short distances
  • Dizziness, lightheadedness, or fainting
  • Fatigue
  • Fluttering or rapid heartbeat
  • Swollen ankles and feet
  • Trouble breathing or feeling short of breath

If you have any of these symptoms, it’s important to see your doctor quickly to confirm or rule out any heart problems.

My Aortic Stenosis Confession: Susan

Treatments for Aortic Stenosis

For some, aortic stenosis doesn’t cause problematic symptoms. If this is the case, your doctor may recommend regular monitoring of your condition and frequent follow-ups to make sure the condition isn’t getting worse. If you only have mild symptoms, lifestyle changes and certain medications may help manage symptoms and lower your risk for complications later.

However, if aortic stenosis symptoms interfere with your daily life, your doctor may suggest more intensive treatment to repair or replace the aortic valve. Sometimes, valve repair is possible, but in most cases aortic stenosis requires the surgical removal and replacement of the aortic valve.

If your doctor recommends aortic valve replacement, expect the damaged valve to be removed and replaced with an artificial heart valve or one made from cow, pig, or human heart tissue. This procedure may be performed using traditional surgical techniques that remove the damaged valve with a healthy replacement, or it may be completed using a less invasive procedure known as transcatheter aortic valve replacement (TAVR).

During TAVR, doctors thread a thin, narrow catheter through a larger blood vessel in your leg or chest. They guide the catheter to your heart and use it to insert a new replacement valve right where the damaged valve resides.

Aortic stenosis is a serious condition that shouldn’t be taken lightly. If you’re slowing down as you age, but you have other symptoms like dizziness or trouble breathing, you should ask your doctor about this possible diagnosis. The sooner the problem’s identified, the sooner you can begin treatment and avoid complications.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 May 24
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