Aortic stenosis (AS) is a narrowing of the aortic valve opening. This valve controls the flow of blood from the heart to a large artery called the aorta. This artery carries blood from the heart to the rest of body.
AS makes it hard for blood to flow out of the heart. It can lower the amount of blood that goes to the body and cause a back-up of blood into the heart. This back-up can raise pressure in the heart and lungs. AS can range from mild to severe.
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The aortic valve is made up of 3 cusps that open and close together. In babies, AS is caused by a birth defect that may result in:
- 1 cusp that cannot open as fully as 3 cusps
- 2 cusps that are damaged
- Cusps that are partly closed or do not open the right way due to thickness
The valve can also be damaged by infection.
Things that may raise a child's risk of AS are:
Mild AS may not cause any problems. More severe AS may cause:
- Extreme lack of energy after activity
- Lightheadedness with activity
- Fainting with activity
- Rapid or irregular heartbeat
- Shortness of breath
- Pain, squeezing, pressure, or tightness of the chest, usually with activity
Rarely, AS may cause heart rhythm problems and sudden death.
The doctor will ask about your child’s symptoms and health history. A physical exam will be done. It will focus on the chest and heart.
Pictures may be taken to view the heart and structures around it. This can be done with:
Mild AS will be monitored for any changes or problems. Treatment may not be needed right away.
Choices for moderate to severe AS are:
- Lifestyle changes, such as avoiding strenuous activities
- Medication to lower stress on the heart and prevent heart failure
Some children may need surgery. Choices are:
American Heart Association http://www.heart.org
National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov
Canadian Cardiovascular Society http://www.ccs.ca
Canadian Society for Vascular Surgery http://www.canadianvascular.ca
Aortic stenosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/aortic-stenosis. Accessed November 2, 2020.
Aortic stenosis in children. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/aortic-valve-stenosis. Accessed November 2, 2020.
Aortic (valve) stenosis in infants and children. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/a/avs. Accessed November 2, 2020.
Baumgartner H, Falk V, et al; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017 Sep 21;38(36):2739-2791.
- Reviewer: EBSCO Medical Review Board Kari Kassir, MD
- Review Date: 09/2020
- Update Date: 05/07/2021