Aortic stenosis awareness

Overview

Aortic stenosis is a condition where the heart's aortic valve becomes narrow and stiff, making it harder for the heart to pump blood out to the rest of the body. Over time, this extra strain can weaken the heart muscle.

Aortic stenosis is fairly common, especially in people over 65. About 1 in 50 people over 65 have some degree of aortic stenosis.

It mostly affects older adults, but it can also occur in younger people who are born with an abnormal aortic valve (bicuspid aortic valve) or who have had rheumatic fever.

Symptoms

Common symptoms

• Shortness of breath, especially during activity or when lying flat.
• Chest pain, tightness, or discomfort (angina).
• Feeling dizzy or lightheaded, especially with activity.
• Fainting (syncope) or nearly fainting.
• Heart palpitations (feeling like your heart is racing or skipping beats).

Symptoms in children

• Tiring easily during play or exercise.
• Poor feeding or slow growth in infants.
• Chest pain or fainting during physical activity.
• A heart murmur heard by a doctor.

Symptoms in older adults

• General weakness and fatigue.
• Shortness of breath with daily activities like walking or climbing stairs.
• Feeling dizzy or lightheaded when standing up quickly.
• Swollen ankles or feet (signs of heart failure).

Causes

Main causes

• Age-related calcium buildup on the valve (most common cause in older adults).
• A congenital (present at birth) bicuspid aortic valve — the valve has two flaps instead of three, which can become stiff over time.
• Rheumatic fever, which can scar the valve in childhood or young adulthood.
• Radiation therapy to the chest for cancer treatment.

Risk factors

• Age — risk increases after age 65.
• High blood pressure.
• High cholesterol.
• Diabetes.
• Kidney disease.
• Being born with a bicuspid aortic valve.
• History of rheumatic fever.
• Smoking.

When to see a doctor

See a doctor urgently if:

• If you have chest pain, fainting, or sudden severe shortness of breath — call your local emergency number immediately.
• If you notice new or rapidly worsening symptoms like dizziness or breathing trouble — see a doctor the same day.

Book a routine appointment if:

• If you have a heart murmur or any symptoms like fatigue, mild shortness of breath, or chest discomfort, make an appointment with your GP or cardiologist.
• If you are over 65 and have not had a heart check-up, ask your doctor about a routine assessment.

Diagnosis

Aortic stenosis is usually first suspected when a doctor hears a heart murmur during a routine check-up. To confirm the diagnosis and assess the severity, you will be referred for further tests.

Tests that may be done

• Echocardiogram (echo) — an ultrasound of the heart that shows how well the valve opens and measures blood flow.
• Electrocardiogram (ECG or EKG) — a quick test of the heart's electrical activity.
• Chest X-ray — to see if the heart is enlarged or if there is fluid in the lungs.
• Stress test — walking on a treadmill or riding a bike while your heart is monitored, to see how it responds to activity.
• Cardiac catheterization — a thin tube is guided to the heart to measure pressure across the valve (sometimes done before surgery).

What to expect at your appointment

Most tests are painless and done as an outpatient. An echocardiogram takes about 30–60 minutes. You may be asked to avoid eating or drinking for a few hours before a stress test or catheterization. Your doctor will explain the results and what they mean for you.

Treatment

Treatment depends on the severity of the stenosis and whether you have symptoms. For mild or moderate aortic stenosis, regular monitoring and lifestyle changes may be enough. For severe symptomatic stenosis, valve replacement is usually needed to improve symptoms and prolong life.

Self-care at home

• Keep all follow-up appointments with your heart doctor for regular scans and check-ups.
• Tell all your doctors and dentist about your valve condition before any procedures or surgeries — you may need antibiotics before dental work to prevent infection.
• Report any new or worsening symptoms as soon as they appear.

Medical treatments

There are no medications that can reverse the valve narrowing. However, your doctor may prescribe medicines to manage related conditions like high blood pressure, heart failure, or abnormal heart rhythms. These drugs help reduce the heart's workload but do not fix the valve itself. Never stop or change medications without talking to your doctor.

When is surgery considered?

When aortic stenosis becomes severe and causes symptoms, the standard treatment is to replace the valve. This can be done through open-heart surgery (surgical aortic valve replacement) or a less invasive procedure called transcatheter aortic valve replacement (TAVI). Your heart team will discuss which option is best for you based on your age, overall health, and the shape of your valve.

Living with this condition

Many people with mild to moderate aortic stenosis feel well and can live normally. You should avoid very strenuous activities like heavy lifting or sprinting if your stenosis is moderate to severe. Listen to your body and rest when you feel short of breath or dizzy.

Lifestyle tips

• Stay physically active within limits — gentle activities like walking, swimming, or cycling are often recommended.
• Avoid smoking and limit alcohol.
• Manage stress through relaxation techniques like deep breathing or meditation.
• Keep your blood pressure and cholesterol under control with a healthy diet and medications if prescribed.

Diet and exercise

A heart-healthy diet low in salt, saturated fats, and added sugars is beneficial. Eat plenty of fruits, vegetables, whole grains, and lean proteins. Exercise regularly, but check with your doctor before starting any new activity. Stop and rest if you feel chest pain, dizziness, or unusual shortness of breath.

Mental health and emotional wellbeing

Living with a heart condition can cause anxiety, worry, or low mood. It is normal to feel concerned about your future health. Talk to your doctor if these feelings affect your daily life. Connecting with others who have similar conditions can also help.

Prevention

Aortic stenosis caused by aging cannot be fully prevented, but you can lower your risk by keeping your heart and blood vessels healthy. Managing conditions like high blood pressure, high cholesterol, and diabetes may slow the progression.

Vaccines

Ask your doctor if you need vaccines for flu and pneumonia. Respiratory infections can put extra strain on the heart, and preventing them is important for people with any heart condition.

Screening programmes

There is no routine screening for aortic stenosis in the general population. However, if you have symptoms or risk factors, your doctor may listen for a heart murmur during a check-up. If you have a bicuspid valve (known from birth), you should have regular echocardiograms as advised by your cardiologist.

Complications

If left untreated

• Heart failure — the heart becomes too weak to pump enough blood.
• Abnormal heart rhythms, including atrial fibrillation.
• Blood clots that can cause stroke or other embolisms.
• Sudden cardiac arrest (the heart stops beating suddenly).

Long-term outlook

The outlook for aortic stenosis is very good when it is detected and treated. For people who undergo valve replacement, symptoms usually improve dramatically, and quality of life returns to near normal. Even without surgery, many people live comfortably for years with mild to moderate stenosis under regular medical supervision. The key is early diagnosis and timely treatment.

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