Managing Aortic Stenosis Symptoms
Quick Facts
- Aortic stenosis can get worse over time, even if you don’t have symptoms at first.
- Managing your heart health and risk factors can help reduce symptoms of aortic stenosis.
- If you need a valve replacement, your doctor will help you choose the best option.
How is mild aortic stenosis managed?
You may have been surprised when your doctor said you have aortic stenosis (AS). This happens when the aortic valve becomes narrow and makes it harder for blood to leave the heart. In mild cases, symptoms are often minor and easy to overlook. Some people may think they are normal signs of aging.
Although you might not have noticed any symptoms, your doctor may have heard a heart murmur during a routine checkup. Or you might feel more tired than usual. These can be signs of early AS. If your doctor thinks you may have AS, they may order an echocardiogram (echo). This test uses sound waves (ultrasound) to create pictures of the heart and heart valves.
Many people with mild AS do not have symptoms until their condition gets worse. As blood flow slows, you may begin to notice shortness of breath or chest pain.
A damaged heart valve will not get better on its own. But there are ways to manage your symptoms and support your heart health. If your AS becomes severe, you may need a procedure to replace your aortic valve.
View the Aortic Stenosis Symptom Tracker (PDF) | Spanish (PDF)
Control risk factors
Managing heart health and risk factors can help reduce your AS symptoms. Talk to your healthcare professional about medications, physical activity and lifestyle recommendations if you have any of these conditions:
Eating healthy, exercising regularly and not smoking will improve your heart health and well-being. Various medications may also lower blood pressure and cholesterol.
Poor oral health, including infected gums (gingivitis and periodontitis), may increase the risk of bacteria entering the bloodstream. This can contribute to infective endocarditis in people at higher risk. Daily dental care and checkups are important.
Get regular checkups
See your primary care doctor or your cardiologist regularly to check your heart. Routine echocardiograms can show if the condition has gotten worse.
If you have new or worsening symptoms before the checkup, call your doctor right away. Also, talk to your doctor if you’re considering pregnancy. If you have severe aortic stenosis and become pregnant, close medical supervision is required before, during and after pregnancy.
How is moderate aortic stenosis managed?
People with moderate AS may not notice symptoms. However, the condition can get worse over time and can lead to serious complications, including heart failure.
Control risk factors
Although you cannot reverse damage to a heart valve, managing other cardiovascular risk factors can improve overall heart health and may help reduce complications associated with AS. For instance, your doctor can prescribe medications to:
- Lower blood pressure and cholesterol
- Regulate abnormal heart rhythms
- Relieve fluid buildup Monitor your symptoms
Monitor your symptoms
If you’ve been diagnosed with moderate AS, you may have no symptoms until the damage to your heart valve is severe. It’s important to be aware of any signs or symptoms that could mean your heart valve is deteriorating.
Call your doctor about new or worsening symptoms, including:
- Chest pain or tightness
- Rapid fluttering heartbeat
- Shortness of breath
- Dizziness or faintness
- Increased exhaustion after activity
- Swollen ankles and feet
- Difficulty sleeping
See your doctor regularly
Follow your doctor’s recommendations about how often you need checkups and tests to monitor your aortic valve. If your AS progresses, talk to a cardiologist about options and whether you are a candidate for heart valve replacement.
How is severe aortic stenosis treated?
Severe AS, sometimescalled a failing heart valve, is a life-threatening condition. It is treated by replacing the aortic valve.
This can be done with open-heart surgery (surgical aortic valve replacement, or SAVR) or a less invasive procedure (transcatheter aortic valve implantation or transcatheter aortic valve replacement, also called TAVI or TAVR). While surgery was once the standard treatment, TAVI is now an option for many people.
After valve replacement, most people feel better and have a higher quality of life.
Transcatheter aortic valve implantation
During a TAVI procedure, an interventional cardiologist places a new valve through an artery in the groin or chest and guides it to the heart. Once it is in place, a small balloon is expanded to secure the new valve in place.
TAVI can be done with sedation or general anesthesia. Many people go home from the hospital within a few days. Time in the hospital may vary based on your age and overall health.
Surgical aortic valve replacement
After general anesthesia is given, a cardiothoracic surgeon makes a cut in the chest. The patient is placed on the heart-lung machine, the heart is opened and the damaged valve is removed. A new valve is then sewn in place.
After this surgery, patients may go home in about a week.
Deciding between TAVI and SAVR
Once your doctor decides you need a new aortic valve, they will explain your options and help you choose what’s best for you. They will also go over the risks and benefits of each option.
Whichever procedure you choose, you will need to see a cardiologist for the rest of your life to make sure your new valve keeps working well.
