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Aortic stenosis - Symptom

Alternative Names

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

Symptoms:

People with aortic stenosis may have no symptoms at all until late in the course of the disease. The diagnosis may have been made when the healthcare provider heard a heart murmur and then performed additional tests.

Symptoms of aortic stenosis include:

Breathlessness with activity
Chest pain, angina-type
- Crushing, squeezing, pressure, tightness
- Pain increases with exercise, relieved with rest
- Under the chest bone, may move to other areas
Fainting, weakness, or dizziness with activity
Sensation of feeling the heart beat (palpitations)

In infants and children, symptoms include:

Becoming tired or fatigued with exertion more easily than others (in mild cases)
Serious breathing problems that develop within days or weeks of birth (in severe cases)

Children with mild or moderate aortic stenosis may get worse as they get older. They also run the risk of developing a heart infection (bacterial endocarditis).

Signs and tests:

The health care provider will be able to feel a vibration or movement when placing a hand over the person's heart. A heart murmur, click, or other abnormal sound is almost always heard through a stethoscope. There may be a faint pulse or changes in the quality of the pulse in the neck (this is called pulsus parvus et tardus).

Infants and children with aortic stenosis may be extremely tired, sweaty, and have pale skin and fast breathing. They may also be smaller than other children their age.

Blood pressure may be low.

The following tests may be performed:

Chest x-ray
Doppler echocardiography
ECG
Exercise stress testing
Left cardiac catheterization
MRI of the heart
Transesophageal echocardiogram (TEE)

Heart, section through the middle

Heart, front view

Aortic stenosis

Heart valves

Reviewed last on: 5/7/2010
Issam Mikati, MD, Associate Professor of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Otto CM, Bonow RO. Valvular heart disease. Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:chap 62.

Fullerton DA, Harken AH. Acquired heart disease: valvular. In: Townsend CM Jr., Beauchamp RD, Evers BM, et al., eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 62.

Nishimura RA, Carabello BA, Faxon DP, et al. ACC/AHA 2008 guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(8):676-685.

Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr., Faxon DP, Freed MD, et al; 2006 Writing Committee Members; American College of Cardiology/American Heart Association Task Force. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients with Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2008;118:e523-e661.

Obstructive lesions. In: Park MK, ed. Pediatric Cardiology for Practitioners. 5th ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 13.

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