(Stenosis, Aortic—Child; AS—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.
AS 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
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.
Factors that may increase your child's chance of AS include:
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
- Palpitations—sensation of rapid or irregular heartbeat
- Shortness of breath
- Lightheadedness with exertion
In rare cases, AS can cause:
- Abnormal heart rhythms—arrhythmia
- Sudden death with no previous symptoms
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
Tests may include:
- Electrocardiogram (EKG)—to measure the heart's electrical activity
- Exercise stress test—the recording of the heart during exercise
Imaging tests evaluate the heart and surrounding structures. This can be done with:
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:
If your child has moderate to severe AS, your child may need to avoid strenuous physical activity., such as playing competitive sports.
If necessary, your child may be given medication to help prevent heart failure.
Severe AS may require surgery. Procedures include:
There are no current guidelines to prevent congenital AS.
American Heart Association
National Heart, Lung, and Blood Institute
Canadian Cardiovascular Society
Canadian Society for Vascular Surgery
Aortic stenosis in children. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/aortic-valve-stenosis. Accessed June 24, 2013.
Aortic valve stenois in children. Cincinnati Children’s website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/aortic-valve-stenosis/overview. Accessed June 24, 2013.
Aortic stenosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 20, 2013. Accessed June 24, 2013.
Last reviewed June 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.