Aortic stenosis (AS) is a narrowing of the aortic valve. This valve controls the flow of blood from the heart to a large artery called the aorta. The aorta carries the blood to the rest of the body.
AS can interfere or block the flow of blood from the heart to the rest of the body. It could also cause a back-up of blood into the heart and lungs. AS can range from mild to severe.
Heart Chambers and Valves
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The aortic valve is normally made up of three cusps that open and close together. In babies, AS is caused by a birth defect of the aortic valve that may result in: 1 cusp that can not open as fully as 3 cusps2 cusps that are damagedCusps that are partly closed or do not open correctly due to thickness
The aortic valve can also be damaged by infection or injury to the valve.
Factors that may increase your child's chance of AS include: Family members with congenital valvular heart diseasesRheumatic fever—which can occur after a strep infectionBacterial endocarditis—infection of the heart
Mild AS may not cause any symptoms. More severe AS may cause: Extreme fatigue after exercise or exertionFainting with exercise or exertionPain, squeezing, pressure, or tightness of the chest, usually occurring with exertionPalpitations—sensation of rapid or irregular heartbeatShortness of breathLightheadedness with exertion
In rare cases, AS can cause:
Abnormal heart rhythms—arrhythmiaSudden death with no previous symptoms
You will be asked about your child’s symptoms and medical history. A physical exam will be done. The doctor may be alerted of AS by the following: Abnormal chest sounds, such as a heart murmur or clickNoticeable chest heave or vibration when the doctor's hand is held over your child’s heart
Tests may include: Electrocardiogram (EKG)—to measure the heart's electrical activityExercise stress test—the recording of the heart during exercise
Imaging tests evaluate the heart and surrounding structures. This can be done with: Chest x-rayEchocardiogramRarely,
Mild AS will be monitored for any changes or complication. Treatment may not be needed right away.
Treatment options for moderate to severe AS may include:
If your child has moderate to severe AS, your child may need to avoid strenuous physical activity., such as playing competitive sports.
If necessary, your child may be given medication to help prevent
Severe AS may require surgery. Procedures include: Balloon valvuloplasty—A balloon device is passed through the arteries to open or enlarge the aortic valve. Since the valve can become blocked again, surgery may need to be repeated.
Aortic valve replacement—Replacement of a defective heart valve.
There are no current guidelines to prevent congenital AS.
Aortic stenosis in children. Boston Children's Hospital website. Available at:
http://www.childrenshospital.org/conditions-and-treatments/conditions/aortic-valve-stenosis. Accessed June 6, 2016.
Aortic (valve) stenois in infants and children. Cincinnati Children’s website. Available at:
http://www.cincinnatichildrens.org/health/a/avs/. Accessed June 6, 2016.
Last reviewed June 2016 by Karri Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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