Aortic stenosis occurs when the aortic valve, located between the heart’s left ventricle and aorta, does not open fully. This decreases blood flow and may lead to chest pain, fainting, or heart failure.
The nationally recognized heart program at Penn State Children’s Hospital offers advanced diagnostic and treatment techniques for aortic stenosis from a team of pediatric cardiologists and cardiac surgeons.
Care at Children's
At the Children’s Hospital, aortic stenosis patients receive comprehensive care from pediatric cardiologists and cardiac surgeons with the support of:
- Pediatric intensivists
- Critical care physicians
- Specialized nursing staff
We’ve received national recognition for our heart program from numerous ranking institutions.
What to expect
During a patient’s evaluation, we will take a medical history and perform a physical exam. Your child’s doctor will listen for a heart murmur or abnormal sound through the stethoscope, and may check for movement or a vibration by placing his or her hand over the patient’s heart.
If aortic stenosis is suspected, the doctor will order an echocardiogram, an imaging test that uses ultrasound to make detailed pictures of the heart. The test is painless and has no side effects.
In addition to other tests, your doctor may also recommend an exercise stress test, during which the patient exercises while his or her heart activity is monitored. The Children’s Hospital has a nationally recognized laboratory that allows us to diagnose problems that might limit a child's activity. It also allows us to provide patients with a safe exercise routine.
The treatment for aortic stenosis depends on your child’s particular condition. Our specialists evaluate each patient’s test results to determine the best course of action, ideally one that keeps the patient active, productive, and safe.
For patients with mild aortic stenosis, the recommended treatment may be regular checkups by a health provider.
Other cases may require more active treatment, such as:
- Refraining from competitive sports or strenuous activity
- Diuretics, nitrates, beta-blockers, or other medication
- Surgery to repair or replace the valve
- Balloon valvuloplasty, a procedure that widens the aortic valve
Aortic stenosis care involves multidisciplinary care from many departments, including:
Our pediatric clinic is located at:
Penn State Children's Heart Group
121 Nye Road, Suite D
Harrisburg, PA 17112
Groups, Classes & Support
Hershey Hearts is a support group for parents, siblings and other family members of children who have been touched by congenital heart disease. This program provides support on a weekly basis to families who have a child receiving inpatient care through one-on-one visitation or telephone contact.
Survival Kits are also available to families when their child is receiving treatment in our Children’s Hospital.
Contact UsHershey Hearts
PO Box 166 Hershey, PA 17033
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Symptoms, Diagnosis & Outlook
As the aortic valve narrows, the left ventricle has to work harder to pump blood out through the valve. To do this extra work, the muscles in the ventricle walls become thicker. This can lead to chest pain.
As the pressure continues to rise, blood may back up into the lungs. Severe aortic stenosis can limit the amount of blood that reaches the brain and the rest of the body.
Aortic stenosis may be present from birth (congenital), but most often it develops later in life. Children with aortic stenosis may have other conditions present from birth.
Aortic stenosis mainly occurs due to the buildup of calcium deposits that narrow the valve. This is called calcific aortic stenosis. The problem mostly affects older people.
Calcification of the valve happens sooner in people who are born with abnormal aortic or bicuspid valves. In rare cases, calcification can develop more quickly when a person has received chest radiation (such as for cancer treatment).
Another cause is rheumatic fever. This condition can develop after strep throat or scarlet fever. Valve problems do not develop for 5 - 10 years or longer after rheumatic fever occurs. Rheumatic fever is becoming rarer in the United States.
Aortic stenosis occurs in about 2% of people over 65 years of age. It occurs more often in men than in women.
Most people with aortic stenosis do not develop symptoms until the disease is advanced. The diagnosis may have been made when the health care provider heard a heart murmur and performed tests.
Symptoms of aortic stenosis include:
- Chest discomfort: The chest pain may get worse with activity and reach into the arm, neck, or jaw. The chest may also feel tight or squeezed.
- Cough, possibly bloody
- Breathing problems when exercising
- Becoming easily tired
- Feeling the heart beat (palpitations)
- Fainting, weakness, or dizziness with activity
In infants and children, symptoms include:
- Becoming easily tired with exertion (in mild cases)
- Failure to gain weight
- Poor feeding
- 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 are also at risk for a heart infection called bacterial endocarditis.
Outlook & Prognosis
The outcome varies. The disorder may be mild and not produce symptoms. Over time, the aortic valve may become narrower. This may result in more severe heart problems such as:
- Atrial fibrillation and atrial flutter
- Blood clots to the brain (stroke), intestines, kidneys, or other areas
- Fainting spells (syncope)
- Heart failure
- High blood pressure in the arteries of the lungs (pulmonary hypertension)
The results of aortic valve replacement are often excellent. To get the best treatment, go to a center that regularly performs this type of surgery.
Call your health care provider if you or your child has symptoms of aortic stenosis.