Carl R. Darnall Army Medical Center - Health Library

Aortic Stenosis—Child

(Stenosis, Aortic—Child; AS—Child)

Definition

Aortic stenosis (AS) is a narrowing of the aortic valve opening. This valve controls the flow of blood from the heart to a large artery called the aorta. This artery carries blood from the heart to the rest of body.

AS makes it hard for blood to flow out of the heart. It can lower the amount of blood that goes to the body and cause a back-up of blood into the heart. This back-up can raise pressure in the heart and lungs. AS can range from mild to severe.

Heart Chambers and Valves
heart anatomy

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Causes  ^

The aortic valve is made up of three cusps that open and close together. In babies, AS is caused by a birth defect that may result in:

  • One cusp that can’t open as fully as three cusps
  • Two cusps that are damaged
  • Cusps that are partly closed or do not open the right way due to thickness

The valve can also be damaged by infection.

Risk Factors  ^

Factors that may raise your child's chance of AS are:

Symptoms  ^

Mild AS may not cause any problems. More severe AS may cause:

  • Extreme lack of energy after activity
  • Lightheadedness with activity
  • Fainting with activity
  • Rapid or irregular heartbeat
  • Shortness of breath
  • Pain, squeezing, pressure, or tightness of the chest, usually with activity

In rare cases, AS can cause:

  • Heart rhythm problems
  • Sudden death with no prior health problems

Diagnosis  ^

You will be asked about your child’s symptoms and health history. A physical exam will be done. The doctor may be alerted of AS by:

  • Unusual chest sounds, such as a heart murmur or click
  • A chest heave or vibration when the doctor's hand is held over your child’s heart

Pictures may be taken to view the heart and structures around it. This can be done with:

Treatment  ^

Mild AS will be monitored for any changes or problems. Treatment may not be needed right away.

Here are options for moderate to severe AS:

Lifestyle Changes

Your child may need to avoid strenuous physical activity, such as competitive sports. Talk to your child’s doctor before your child starts an exercise program.

Medications

If needed, your child may be given medicine to lower stress on the heart and help prevent heart failure.

Surgery

Severe AS may need surgery. Options are:

  • Balloon valvuloplasty—A balloon device is passed through the arteries to open the aortic valve or make it bigger. Since the valve can become blocked again, this may need to be repeated.
  • Aortic valve replacement—A defective heart valve is replaced.

Prevention  ^

Congenital AS can’t be prevented.

RESOURCES:

American Heart Association
http://www.heart.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca

Canadian Society for Vascular Surgery
http://www.canadianvascular.ca

REFERENCES:

Aortic stenosis in children. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/aortic-valve-stenosis. Accessed June 28, 2018.

Aortic (valve) stenois in infants and children. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/a/avs/. Updated June 2015. Accessed June 28, 2018.

Aortic stenosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114195/Aortic-stenosis. Updated January 26, 2018. Accessed June 28, 2018.

Last reviewed June 2018 by Kari Kassir, MD  Last Updated: 6/28/2018