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 cannot 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

Things that may raise a child's risk 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

Rarely, AS may cause heart rhythm problems and sudden death.

Diagnosis

The doctor will ask about your child’s symptoms and health history. A physical exam will be done. It will focus on the chest and 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.

Choices for moderate to severe AS are:

  • Lifestyle changes, such as avoiding strenuous activities
  • Medication to lower stress on the heart and prevent heart failure

Some children may need surgery. Choices are:

Prevention

There are no known guidelines to prevent this health problem.

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 November 2, 2020.

Aortic (valve) stenois in infants and children. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/a/avs. Accessed November 2, 2020.

Aortic stenosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/aortic-stenosis. Accessed November 2, 2020.

Baumgartner H, Falk V, et al; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017 Sep 21;38(36):2739-2791.

Last reviewed September 2020 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 11/2/2020