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What is aortic valve stenosis?

Aortic stenosis (AS) is one of the most common and serious valve disease problems. It happens when the aortic valve opening becomes narrow, which limits blood flow from the left ventricle to the aorta.

This reduced blood flow can increase pressure inside the heart. Over time, that pressure can affect the left side of the heart and how the heart fills and pumps blood.

Some people are born with a heart valve problem, such as a bicuspid aortic valve. More often, AS develops with age as calcium builds up or scar tissue forms on the valve. This can make the valve stiff and restrict how much blood can pass through.

Access our aortic stenosis fact sheet (PDF) | Spanish (PDF)

Does aortic stenosis always produce symptoms?

No. Many people with aortic stenosis don’t notice symptoms until blood flow becomes more limited.

Symptoms of aortic stenosis may include:

• Chest pain
• Rapid, fluttering heartbeat
• Trouble breathing or feeling short of breath
• Feeling dizzy or light-headed
• Fainting
• Difficulty walking short distances
• Fatigue
• A drop in activity level or ability to do normal daily activities

Someone with AS may not report symptoms. But if you or someone close to you notices unusual fatigue, a decline in everyday activity or other symptoms, you should talk with a healthcare professional.

You can use our AS symptom tracker (PDF) to record your symptoms and how often they happen, and take it to your next appointment.

Infants and children with aortic stenosis due to a congenital defect may have symptoms such as:

• Getting tired during activity
• Not gaining weight as expected
• Poor feeding
• Breathing problems

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How does aortic stenosis progress or cause increasing problems?

In addition to the symptoms such as feeling faint, weak or tired, AS makes the left ventricle work harder to pump blood through the narrowed valve into the aorta.

Over time, the muscle of the left ventricle can become thicker. When this happens, the chamber has less space to fill with blood, which can reduce how much blood the heart sends to the body.

This can lead to heart failure. Treatment can help slow the disease and, in some cases, improve how the heart works.

Management and treatment depend on the cause of the condition and how advanced it is.

Aortic stenosis is classified into four stages:

• Stage A: At risk of developing the condition
• Stage B: The valve is narrowing, and blood flow is becoming more limited
• Stage C: Severe narrowing without symptoms
• Stage D: Severe narrowing with symptoms

What causes aortic stenosis?

Aortic stenosis most often affects older adults. It usually develops over time as calcium builds up and scarring forms on the valve cusp (flap or fold). This can make the valve stiff and narrow. It often begins after age 60 but may not cause symptoms until later in life, often in the 70s or 80s.

It can also develop after rheumatic fever in childhood.

Aortic stenosis in the young 

Some people are born with a heart valve problem. One common example is a bicuspid aortic valve, where the valve has only two cusps instead of three. This can increase the risk of AS.

In some cases, the valve opening may not grow as the heart grows. This can make the heart work harder to pump blood through a smaller opening. Over time, the valve can become stiff and narrow, often due to calcium buildup.

How is aortic stenosis treated?

If you don’t have symptoms or if your symptoms are mild, your healthcare professional may recommend regular checkups to monitor your condition and watch for any changes.

An echocardiogram is commonly used to check the valve and help guide treatment decisions.

Treatments may include medications, valve repair or valve replacement. The right option depends on the cause of your condition and how advanced it is.

Talking with your healthcare team can help you understand your options and decide what’s best for you.

Additional resources:

• Understanding Aortic Stenosis (PDF)
• Aortic Stenosis Fact Sheet (PDF) | Spanish (PDF)
• Aortic Stenosis Symptom Tracker (PDF) | Spanish (PDF)
• Aortic Stenosis Discussion Guide: Get the most out of your appointment (PDF) | Spanish (PDF)
• Aortic Stenosis: Considerations for Replacing Your Aortic Valve (PDF)
• Answers by Heart sheets:
  • What is Aortic Stenosis? (PDF) | Spanish (PDF)
  • Why Do I Need Heart Valve Surgery? (PDF)
• Print our handy pre-surgery checklist: Facing and Recovering from Major Surgery (PDF)(link opens in new window) | Spanish (PDF)