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At the University of Maryland Heart and Vascular Center, our valve disease specialists have years of experience diagnosing and treating all types of valve disease, including valve stenosis, which is most commonly seen in the aortic valve.
Our expert team includes dedicated cardiologists, surgeons, radiologists, nursing specialists and anesthesiologists all specially trained to care for patients with valve disease.
Learn more about our services by downloading our Heart Valve Patient Guide.
What is Aortic Stenosis?Toggle accordion item
A narrowing of a heart valve is called stenosis. The smaller opening causes the heart to work harder, and the body may receive less oxygen-rich blood. Eventually the heart muscles weaken, which increases the risk of heart failure.
Aortic stenosis (AS), a narrowing of the aortic valve, is a common valve problem. There are two main causes of AS:
- Birth defect: Some people are born with an aortic valve that has two of the three flaps (leaflets) fused together. These bicuspid valves are a congenital defect and can restrict blood flow, though problems may not appear until adulthood.
- Aging: Aortic stenosis is more commonly caused by calcium, a mineral naturally found in the blood. Over the years, calcium can collect on the valve as blood flows by, eventually stiffening and narrowing the valve. While this acquired, degenerative problem usually begins after age 60, it may not cause symptoms for a decade or more.
Aortic stenosis is also occasionally caused by radiation therapy to the chest, some medications, inflammation of the heart’s membrane or rheumatic fever, which can develop when strep throat or scarlet fever are not properly treated.
Aortic Stenosis SymptomsToggle accordion item
Obstructed blood flow from aortic stenosis can cause part of the heart muscle to overcompensate and enlarge.
Some patients with a narrowed aortic valve may not experience symptoms until blood flow is significantly restricted. If symptoms do develop, they can range from mild discomfort to preventing patients from climbing stairs or walking even short distances.
Aortic stenosis symptoms can include:
- Shortness of breath
- Chest pain or tightness
- Fainting (syncope)
- Rapid or irregular heartbeat (arrhythmia)
- Extreme fatigue
- Lightheadedness or dizziness
- Difficulty exercising
Aortic Stenosis DiagnosisToggle accordion item
Assessing stenosis symptoms and tests results requires specialized expertise like that offered by our doctors. Otherwise, patients with a valve narrowing may mistakenly get treated for the flu or heart failure.
The main diagnostic tool for suspected stenosis is a heart ultrasound (echocardiogram), a test used by a wide range of doctors.
Even if an echocardiogram finds just a modest narrowing, our specialists would like to see you to establish a relationship with you and your primary care doctor or cardiologist. That way, we can schedule elective surgery if needed, rather than wait until an emergency develops. Learn more about cardiac diagnosis.
Aortic Stenosis TreatmentToggle accordion item
After your diagnosis, we will discuss your treatment options. Our team treats a high volume of patients every year, giving us unparalleled experience and expertise in treating even the most difficult-to-treat conditions.
Learn more about our dedicated care for aortic valve disease patients at our Valve Disease Program.
Your specific course of treatment depends on your symptoms:
- Monitoring: If there are no symptoms or mild symptoms, we may recommend regular monitoring.
- Surgery: If symptoms develop or worsen, you may need surgery to repair or replace the valve. Sometimes, we recommend replacement even for patients with mild or no symptoms, if tests results warrant it. Learn more about aortic valve replacement.
Surgical options include:
- Surgical aortic valve replacement: We remove the damaged heart valve and replace it with a prosthetic valve. Learn more about valve surgery.
- Transcatheter aortic valve replacement (TAVR): This is a minimally invasive procedure to replace the valve without open heart surgery. Learn more about TAVR.
- Robotic assisted surgery: Our doctors have pioneered a minimally invasive alternative procedure to treat aortic stenosis. More than 70,000 patients in the United States undergo replacement of the aortic valve every year. Learn more about aortic valve bypass surgery.
Without surgery, severe stenosis can threaten your life. Valve replacement is highly effective at restoring blood flow, relieving symptoms, reducing heart strain and preventing sudden death. Even the sickest patients can benefit, thanks to the minimally invasive approaches our doctors specialize in.
Learn more about aortic valve replacement.
Mitral Valve StenosisToggle accordion item
Mitral valve stenosis is almost always caused by rheumatic fever, a childhood illness that sometimes occurs after untreated strep throat or scarlet fever. Rheumatic fever is very rare in this country due to the use of effective antibiotics to prevent infections.