Aortic Stenosis -- Child

Aortic stenosis (AS) is a narrowing of the aortic valve. This valve controls the flow of blood from the heart to a large artery called the aorta. The aorta carries the blood to the rest of the body. Aortic stenosis can interfere or block the flow of blood from the heart to the rest of the body. It could also cause a back-up of blood into the heart and lungs. AS can range from mild to severe.

  • Causes

    The aortic valve is normally made up of three cusps that open and close together. In babies, AS is caused by a birth defect of the aortic valve that may result in:

    • One cusp that can not open as fully as three cusps
    • Two cusps that are damaged
    • Cusps that are partly closed or do not open correctly due to thickness

    The aortic valve can also be damaged by infection or injury to the valve.

  • Definition

    Aortic stenosis (AS) is a narrowing of the aortic valve. This valve controls the flow of blood from the heart to a large artery called the aorta. The aorta carries the blood to the rest of the body.

    Aortic stenosis can interfere or block the flow of blood from the heart to the rest of the body. It could also cause a back-up of blood into the heart and lungs. AS can range from mild to severe.

    Heart Chambers and Valves
    heart anatomy
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. The doctor may be alerted of AS by the following:

    • Abnormal chest sounds, such as a heart murmur or click
    • Noticeable chest heave or vibration when the doctor's hand is held over your child’s heart

    To confirm the diagnosis, tests may include:

    • Chest x-ray
      —to take pictures of structures inside the chest
    • Electrocardiogram
      (ECG, EKG)—to measure the heart's electrical activity; may show signs of heart strain or enlargement
    • Echocardiogram
      —to examine the size, shape, and motion of the heart
    • Exercise stress test
      —the recording of the heart during exercise
    • Cardiac catheterization
      (rarely done)—an x-ray of the heart's circulation

  • Prevention

    Congenital AS cannot be prevented.

  • Risk Factors

    Factors that increase your child's chance of developing AS include:

    • Family members with congenital heart disease that affects valves
    • Rheumatic fever
      (usually occurring after a
      Streptococcus
      infection)
    • Bacterial endocarditis
      —infection of the heart

    Tell the doctor if your child has any of these risk factors.

  • Symptoms

    Mild AS may not cause any symptoms. More severe AS may cause:

    • Extreme fatigue after exercise or exertion
    • Fainting with exercise or exertion
    • Pain, squeezing, pressure, or tightness of the chest, usually occurring with exertion
    • Sensation of rapid or irregular heartbeat (palpitations)
    • Shortness of breath
    • Dizziness with exertion

    In rare cases, AS can cause:


    • Abnormal heart rhythms (
      arrhythmia
      )
    • Sudden death with no previous symptoms

  • Treatment

    Mild AS will be monitored for any changes or complication. Treatment may not be needed right away.

    Treatment options for moderate to severe AS may include: