Aortic Stenosis
Informed by recognized medical guidance
Overview
Aortic stenosis happens when the heart's aortic valve becomes narrow. This valve normally opens fully to let blood flow from the heart to the rest of the body. When it narrows, the heart must work harder to pump blood, which can strain the heart over time.
Key facts
- It is a progressive condition, meaning it usually gets worse slowly over many years.
- Many people with mild aortic stenosis have no symptoms at first.
- Regular check-ups are important to monitor valve function and decide the best time for treatment.
It is fairly common, especially in people over 65. About 1 in 8 older adults may have some degree of aortic stenosis, though many have only a mild form.
It most often affects older adults due to natural wear and tear on the valve. Some people are born with a valve that has two flaps instead of three (bicuspid valve), which can cause problems earlier in life. Less commonly, it can be caused by rheumatic fever.
Symptoms
- Chest pain that lasts more than a few minutes or is severe
- Fainting or passing out
- Severe shortness of breath at rest
- Blue or pale lips, skin, or fingertips
- ⚠New or worsening shortness of breath
- ⚠Dizziness that keeps coming back
- ⚠Chest discomfort that goes away with rest
- ⚠Rapid or irregular heartbeat
Common symptoms
- Shortness of breath, especially during activity
- Chest pain, tightness, or pressure
- Dizziness or fainting, especially during exertion
- Heart murmur (an extra or unusual sound heard with a stethoscope)
- Fatigue or feeling unusually tired
Symptoms in children
- Poor feeding and slow weight gain in infants
- Tiring easily during play or exercise
- Chest pain or fainting during physical activity
Symptoms in older adults
- The same common symptoms, but sometimes they are mistaken for normal aging
- Swelling in the ankles and feet as the heart struggles to keep up
- Increased need for sleep or rest
Causes
Main causes
- Age-related calcium buildup on the valve, making it stiff
- A congenital (present at birth) bicuspid aorta valve with two flaps instead of three
- Scarring from a past infection like rheumatic fever (more common in developing countries)
Risk factors
- Being over 65 years old
- High blood pressure
- High cholesterol
- Diabetes
- Chronic kidney disease
- Past radiation therapy to the chest
When to see a doctor
See a doctor urgently if:
- Call your healthcare provider or go to urgent care if you have new symptoms such as frequent dizziness, chest discomfort, or shortness of breath during everyday activities.
Book a routine appointment if:
- If you have a heart murmur or a family history of aortic stenosis, discuss it with your doctor and schedule regular check-ups.
Diagnosis
Your doctor will start by asking about your symptoms, listening to your heart, and feeling your pulse. If they suspect aortic stenosis, they will usually refer you for an echocardiogram, which uses sound waves to create a picture of your heart and valves.
Tests that may be done
- Echocardiogram (echo)
- Electrocardiogram (ECG) to check heart rhythm
- Chest X-ray to see the size of the heart
- Cardiac MRI or CT scan in some cases
- Exercise stress test to see how your heart responds to activity
What to expect at your appointment
You will likely see a cardiologist (heart specialist). The most important test is the echocardiogram, which can show how narrow the valve is and how well your heart is pumping. This is a painless test that usually takes 30 minutes.
Treatment
Treatment depends on how severe the stenosis is and whether you have symptoms. Mild cases may only need monitoring and healthy lifestyle changes. More advanced cases may require a procedure to repair or replace the valve.
Self-care at home
- Follow your doctor's advice about regular activity and rest
- Learn to recognize symptoms that mean you need help
- Keep all follow-up appointments
- Maintain a heart-healthy lifestyle with a balanced diet and no smoking
Medical treatments
Your doctor may prescribe medications to help reduce blood pressure, remove extra fluid, or relieve chest discomfort. These medicines do not fix the valve narrowing but can help manage symptoms and ease the workload on your heart. Do not stop or change any medication without talking to your doctor.
When is surgery considered?
If the stenosis is severe or symptoms become serious, a valve replacement procedure may be recommended. This can be done with open-heart surgery or, in some cases, a less invasive method called transcatheter aortic valve implantation (TAVI). Your heart team will help you decide what is best for your situation.
Living with this condition
Many people with mild aortic stenosis live full and active lives. The key is to listen to your body. If certain activities cause chest pain or dizziness, slow down and mention it to your doctor. You may need to avoid very intense exertion, but moderate activity is often encouraged.
Lifestyle tips
- Quit smoking if you smoke
- Limit alcohol to the amount your doctor advises
- Keep blood pressure and cholesterol in a healthy range
- Get enough sleep and manage stress
Diet and exercise
A heart-healthy diet rich in vegetables, fruits, whole grains, and lean proteins can help. Exercise, such as walking or cycling, can improve fitness and overall health, but check with your doctor about what level is safe for you.
Mental health and emotional wellbeing
Living with a heart condition can cause worry or sadness. It is normal to feel anxious. Talk to your doctor or a counselor if you need support. Consider joining a support group for people with heart conditions.
Prevention
You cannot always prevent aortic stenosis, especially the age-related form. However, you can reduce your risk of heart disease by controlling blood pressure, eating well, staying active, and not smoking.
Vaccines
Keep up to date with recommended vaccines, including flu and pneumonia vaccines, because infections can make heart conditions worse.
Screening programmes
There is no routine screening test for everyone, but if you have a heart murmur or risk factors, your doctor may recommend regular check-ups and imaging.
Complications
If left untreated
- Heart failure, where the heart cannot pump enough blood
- Irregular heartbeats that may need treatment
- Blood clots that can lead to stroke
Long-term outlook
The outlook is good with proper monitoring and timely treatment. Many people with aortic stenosis lead long, active lives after valve replacement. Even without surgery, mild cases often remain stable for years. Your healthcare team will help you stay on top of your health.
Find support
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: August 2, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.