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Aortic stenosis

  • Alternative Names

    Aortic valve stenosis; Left ventricular outflow tract obstruction; Rheumatic aortic stenosis; Calcium aortic stenosis


    Treatment

    If there are no symptoms or symptoms are mild, you may only need to be monitored by a health care provider.

    Patients with significant aortic stenosis are usually told not to play competitive sports, even if they don't have symptoms. If symptoms do occur, strenuous activity must be limited.

    Medications are used to treat symptoms of heart failure or abnormal heart rhythms (most commonly atrial fibrillation). These include diuretics (water pills), nitrates, and beta-blockers. High blood pressure should also be treated.

    Antibiotics may be used for some people with aortic stenosis:

    • People who had rheumatic fever in the past may need long-term, daily treatment with penicillin.
    • In the past, most patients with heart valve problems such as aortic stenosis were given antibiotics before dental work or an invasive procedure, such as colonoscopy. The antibiotics were given to prevent an infection of the damaged heart valve. However, antibiotics are now used much less often before dental work and other procedures.

    Patients should stop smoking and be treated for high cholesterol.

    People with aortic stenosis should see a cardiologist every 3 to 6 months.

    Surgery to repair or replace the valve is the preferred treatment for adults or children who develop symptoms. Even if symptoms are not very bad, the doctor may recommend surgery. People with no symptoms but worrisome results on diagnostic tests may also require surgery.

    A less invasive procedure called balloon valvuloplasty may be done in children instead. This is a procedure in which a balloon is placed into an artery in the groin, advanced to the heart, placed across the valve, and inflated. This may relieve the blockage caused by the narrowed valve.

    Some children may require aortic valve repair or replacement. If possible, the pulmonary valve may be used to replace the aortic valve.

    Children with mild aortic stenosis may be able to participate in most activities and sports.

    See also:

    • Aortic valve surgery - minimally invasive
    • Aortic valve surgery - open
    • Heart failure

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    Expectations (prognosis)

    Without surgery, a person with aortic stenosis who has angina or signs of heart failure may do poorly.

    Aortic stenosis can be cured with surgery. After surgery there is a risk for irregular heart rhythms, which can cause sudden death, and blood clots, which can cause a stroke. There is also a risk that the new valve will stop working and need to be replaced.


    Complications
    • Arrhythmias
    • Endocarditis
    • Left-sided heart failure
    • Left ventricular hypertrophy (enlargement) caused by the extra work of pushing blood through the narrowed valve

    Calling your health care provider

    Call your health care provider if you or your child has symptoms of aortic stenosis. For example, call if you or your child has a sensation of feeling the heart beat (palpitations) for more than a short period of time.

    Also contact your doctor immediately if you have been diagnosed with this condition and your symptoms get worse or new symptoms develop.