This condition may be caused by:

• Build-up of calcium around and on the aortic valve. This can occur with ageing. This is the most common cause of aortic valve stenosis.

• A heart problem that developed in the womb (birth defect).

• Rheumatic fever.

• Radiation to the chest.

You are more likely to develop this condition if:

• You are 65 years and older.

• You were born with an abnormal bicuspid valve.

You may not have any symptoms until your condition becomes severe. It may take 10–20 years for mild or moderate aortic valve stenosis to become severe. Symptoms may include:

• Shortness of breath. This may get worse during physical activity.

• Feeling unusually weak and tired (fatigue).

• Extreme discomfort in the chest, neck, or arm during physical activity (angina).

• A heartbeat that is irregular or faster than normal (palpitations).

• Dizziness or fainting. This may happen when you get tired or after you take certain heart medicines, such as nitroglycerin.

This condition may be diagnosed with:

• A physical examination.

• Echocardiogram. This is a type of imaging test that uses sound waves (ultrasound) to make images of your heart. There are two kinds of this test that may be used.

  • Transthoracic echocardiogram (TTE). For this type, a wand-like tool (transducer) is moved over your chest to create ultrasound images that are recorded by a computer.

  • Transoesophageal echocardiogram (TOE). For this type, a flexible tube (probe) is inserted down the part of the body that moves food from your mouth to your stomach (oesophagus). The heart and the oesophagus are close to each other. Your healthcare provider will use the probe to take clear, detailed pictures of the heart.

• Cardiac catheterisation. For this procedure, a small, thin tube (catheter) is passed through a large vein in your neck, groin, or arm. The catheter is used to get information about arteries, structures, blood pressure, and oxygen levels in your heart.

• Exercise stress tests. These are tests that check the blood supply to your heart and your heart’s response to exercise. These tests help determine the severity of your condition.

• Cardiac magnetic resonance imaging (MRI). This test uses magnetic fields and radio waves to create detailed images of your heart. It is used to look at the size of your aorta.

• Computed tomography, or CT scan. This is a test that uses a series of X-rays and a computer to produce a 3D image of the heart. This test may be used to measure the size of your aorta and look at your aortic valve more closely.

Treatment depends on how severe your condition is and what your symptoms are. You will need to have your heart checked regularly to make sure that your condition is not getting worse or causing serious problems. Treatment may include:

• Surgery to replace your aortic valve. This is the most common treatment for aortic valve stenosis, and it is the only treatment to cure the condition. Several types of surgeries are available. The surgery may be done:

  • Through a large incision over your heart (open-heart surgery).

  • Through small incisions, using a flexible tube called a catheter (transcatheter aortic valve replacement, TAVR).

• Medicines that help to keep your heart rate regular.

• Medicines that thin your blood (anticoagulants) to prevent blood clots.

• Antibiotics to help prevent infection.

Lifestyle

• If you drink alcohol:

  • Limit how much you have to:

    • 0–1 drink a day for women.

    • 0–2 drinks a day for men.

  • Know how much alcohol is in your drink.

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco and vaping devices, such as e-cigarettes. If you need help quitting, ask your healthcare provider.

• Work with your healthcare provider to manage your blood pressure and cholesterol.

• Maintain a healthy weight.

Eating and drinking

Activity

• Exercise regularly.

  • If your aortic valve stenosis is mild, you may only need to avoid very intense physical activity, such as heavy weight lifting.

  • The more severe your aortic valve stenosis is, the more activities you may need to avoid.

• Return to your normal activities as instructed by your healthcare provider. Ask your healthcare provider what amount and type of physical activity is safe for you.

If you are taking blood thinners:

• Talk with your healthcare provider before you take any medicines that contain aspirin or NSAIDs. These medicines increase your risk for dangerous bleeding.

• Take your medicine exactly as told, at the same time every day.

• Avoid activities that could cause injury or bruising. Follow instructions about how to prevent falls.

• Wear a medical alert bracelet or carry a card that lists what medicines you take.

General instructions

• Take over-the-counter and prescription medicines only as instructed by your healthcare provider.

• If you were prescribed an antibiotic, take it as instructed by your healthcare provider. Do not stop taking the antibiotic even if you start to feel better.

• If you are a woman and you plan to become pregnant, talk with your healthcare provider before you become pregnant.

• Before you have any type of medical or dental procedure or surgery, tell all healthcare providers that you have aortic valve stenosis. This may affect treatment that you receive.

• Keep all follow-up appointments. This is important.

These symptoms may be an emergency. Get help right away. Call your local emergency services.

• Do not wait to see if the symptoms will go away.

• Do not drive yourself to the hospital.