Aortic Valve Stenosis

This is a narrowing of the opening of the aortic valve. It is due to abnormalities or aging of the valve.

About 5% of heart defects are due to aortic valve stenosis. However, there may be many cases that are not diagnosed. It is likely that this is the most common cardiac defect.

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Symptoms

Severe blockage may cause chest pain or feeling a loss of consciousness with activity. Symptoms depend on what caused the blockage.

Sometimes a defective aortic valve becomes blocked when the person is an adult.

Less commonly, the valve defect may occur in infancy. It can produce severe blockages to the flow of blood out of the heart and heart failure.

More often, symptoms occur in later childhood. They include a blocked aortic valve and a lack of oxygen. There are usually no other symptoms, although a heart murmur can be heard. Abnormal sounds caused by the closing of the valve may also be heard. A complication of the condition can be an infection in the heart.

Causes and Risk Factors

The narrowing may occur in the valve, below it or above it. Sometimes blockages that happen above the valve because too much calcium is in the blood. They may be accompanied by peripheral pulmonary artery stenosis. Blocks below the valve are sometimes caused by a ridge built up of fibers of tissue. They may also be caused by a build-up of muscle.

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Diagnosis

An electrocardiogram (ECG) can show changes and signs of overdevelopment in the left ventricle.

An X-ray may show a widening of the aorta as it rises. An X-ray may also show excessive growth of the left ventricle. This is true if the blockage has been going on for a long time.

An evaluation using echocardiography, cardiac catheterization and angiocardiography may be needed. These will be used if there are signs of a severe block or, if there are symptoms such as chest pain that occurs with exercise or if a person loses consciousness.

Rarely, these valve problems may occur in infancy, such as poor blood flow, anemia, and heart failure.

The doctor may order ECG tests and X-rays to confirm diagnosis of valve problems.

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Treatments

Treatment will vary depending on the severity and cause of the symptoms.

If the defect causes life-threatening heart failure in infancy, immediate surgery to repair the valve will be necessary. Results from this type of surgery vary. Sometimes the valve will keep working improperly.

Valve replacement is usually needed by mid- to late childhood. Sometimes it can be delayed until adulthood.

If the blockage is caused by a ridge of fiber-like tissue, this tissue will need to be removed. However, the tissue can grow back. Surgery may be needed again.

Antibiotics may be given to prevent infections in the heart.

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