Aortic stenosis occurs when one of the heart valves thickens and doesn’t open properly. The aortic valve can become damaged, usually over a period of many years. Aortic stenosis is most common in people aged over 65. There are often no symptoms and is usually diagnosed by a cardiologist.
About aortic stenosis
In the early stages, parts of the valve become thickened with calcium, which is known as aortic sclerosis. This is common in people as they get older. About one in four people over the age of 65 have this. This can lead to aortic stenosis where the valve becomes narrowed, and can lead to reduced blood flow from the heart.
Progression to aortic stenosis occurs as people get older, but the rate that this happens at varies. It is estimated that 3-5 per cent of people over the age of 65 may have aortic stenosis.
Most people do not experience symptoms. For those who have the most valve narrowing, or experience significant symptoms, cardiologists (heart specialists) and surgeons will discuss their case to see if they could be helped by an operation.
Symptoms of aortic stenosis
Many people have aortic stenosis and have no symptoms at all, including some individuals who have disease that looks severe on echocardiography.
Symptoms related to aortic stenosis include:
Diagnosing aortic stenosis
Aortic stenosis is usually diagnosed using echocardiography (an echo) which is a way of viewing the heart structure using ultrasound. Other tests may include an electrocardiogram (ECG) or a treadmill test.
Patients are referred for echocardiography if their doctor suspects valve problems following clinical examination, such as detecting a murmur, or they have symptoms suggestive of aortic stenosis.
When to seek medical help
Anyone with chest pain or shortness of breath that starts suddenly should call 999.
If you have aortic stenosis and have been experiencing new or worsening symptoms, such as chest pain, fainting or severe shortness of breath not relieved by rest or medicines you should go to your local Emergency Department.
Treating aortic stenosis
Most people with aortic stenosis do not require treatment. You may need to be followed up regularly to make sure that it is not getting worse.
This will usually involve a routine echo every one to three years, depending on how narrowed the valve is. More severe disease needs more frequent monitoring.
Not all people with aortic stenosis experience symptoms or require treatment, but it is important to identify the patients who need treatment early. This is why follow-up will be offered to all patients.
If you haven’t had a review in a long time
If you have aortic stenosis and are not under the care of a cardiologist (heart specialist) or cardiac surgeon (heart surgeon), speak to your GP. They may need to refer you back to the hospital for follow up.
If you are already under the care of cardiology contact your cardiologist’s secretary – they will be able to tell you when the next review can be expected.
Good dental hygiene and avoiding new piercings and tattoos
If an infection occurs in a tooth this can occasionally travel around the body and infect the valve causing more damage. This is best prevented by regular dental check-ups and teeth-brushing. It is also best to avoid new piercings or tattoos as they can introduce infection.
If you develop severe aortic stenosis
If you develop severe aortic stenosis, you may need surgery to replace the valve. Regular reviews are needed to make sure that if you do need this treatment, that you get it in time to prevent any permanent damage to your heart, or other complications.
If you develop more severe aortic stenosis, you will need further tests. Your doctor will discuss the best treatment options with you.