Aortic Valve Stenosis (Calcific)
What is Aortic Valve Stenosis (Calcific)?
Aortic valve stenosis is a narrowing of the aortic valve in your heart. This valve controls blood flow from your heart to the rest of your body. When calcium deposits build up on the valve leaflets, the opening becomes smaller and stiffer.
Your heart has to work harder to push blood through the narrowed valve. Over time, this extra strain weakens your heart muscle. The calcific form is the most common type in adults and develops gradually over many years.
Many people live with mild stenosis for decades without symptoms. As the valve narrows further, you may experience chest pain, fatigue, or shortness of breath. Early detection helps you and your doctor plan treatment before serious complications develop.
Symptoms
- Chest pain or tightness, especially during physical activity
- Shortness of breath with exertion or when lying flat
- Fatigue and reduced ability to exercise
- Dizziness or fainting during activity
- Heart palpitations or irregular heartbeat
- Swollen ankles and feet
- Heart murmur detected during exam
Many people have no symptoms in the early stages. The condition can progress silently for years before you notice any problems. Regular heart monitoring is important if you have risk factors.
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Causes and risk factors
Calcium buildup on the aortic valve is the main cause of stenosis in older adults. This process resembles how calcium deposits form in your arteries. Age is the biggest risk factor, with most cases appearing after age 65. Congenital heart defects like bicuspid aortic valve increase your risk at younger ages. Other factors include high cholesterol, high blood pressure, chronic kidney disease, and history of rheumatic fever.
Lipoprotein(a) is a blood particle that promotes valve calcification. When Lp(a) levels are elevated, oxidized fats and inflammatory substances accumulate on your valve leaflets. This speeds up calcium deposits and makes stenosis progress faster. Lp(a) levels are mostly determined by your genes and stay fairly stable throughout life. Testing your Lp(a) helps identify if you have higher genetic risk for valve disease.
How it's diagnosed
Your doctor diagnoses aortic stenosis through a physical exam, listening for a heart murmur. An echocardiogram is the main test that shows how narrow your valve is and how well your heart pumps. This ultrasound of your heart measures blood flow velocity and valve opening size. Your doctor may also order an ECG to check your heart rhythm and a chest X-ray to look at heart size.
Blood testing for Lipoprotein(a) helps assess your genetic risk for valve calcification. Elevated Lp(a) is linked to faster stenosis progression and earlier need for valve replacement. Rite Aid offers Lipoprotein(a) testing as an add-on to help you understand your cardiovascular risk. Testing at a Quest Diagnostics location near you makes it easy to monitor this important biomarker.
Treatment options
- Regular monitoring with echocardiograms to track progression
- Heart-healthy diet low in saturated fat and sodium
- Blood pressure management with medications if needed
- Cholesterol-lowering statins to reduce further calcification
- Maintaining healthy weight and staying physically active within limits
- Avoiding strenuous exercise if stenosis is severe
- Valve replacement surgery when stenosis becomes severe and causes symptoms
- Transcatheter aortic valve replacement as a less invasive option
- Balloon valvuloplasty for temporary relief in some cases
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- Simple blood draw at your nearest lab
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Frequently asked questions
Aortic sclerosis is mild thickening and calcium buildup on the valve without narrowing. Aortic stenosis means the valve opening has narrowed enough to restrict blood flow. Sclerosis often progresses to stenosis over time. Both show up on echocardiograms, but stenosis requires closer monitoring and treatment.
Currently, no medications or lifestyle changes can reverse existing calcium deposits on the valve. However, managing risk factors like high cholesterol and blood pressure may slow progression. When stenosis becomes severe and causes symptoms, valve replacement is the only treatment. Early intervention with lifestyle changes may prevent or delay progression.
Lp(a) carries oxidized fats and inflammatory particles that stick to valve tissue. These substances trigger calcium deposits to form on your valve leaflets. People with high Lp(a) tend to develop more severe stenosis and need valve replacement earlier. Testing your Lp(a) level helps predict how fast your valve disease might progress.
If you have elevated Lp(a) or other risk factors, your doctor may recommend an echocardiogram every few years. Once mild stenosis is detected, you may need yearly or twice-yearly monitoring. Lp(a) testing is typically done once since your level stays stable over time. Regular blood pressure and cholesterol checks are also important.
Seek immediate medical attention for chest pain, severe shortness of breath, or fainting episodes. These symptoms may signal that your stenosis has become severe. Even mild symptoms like fatigue or dizziness during activity warrant a doctor visit soon. Early evaluation helps prevent sudden heart complications.
With mild stenosis, most people can continue normal physical activity. As stenosis progresses to moderate or severe, your doctor may restrict high-intensity exercise. Strenuous activity can be dangerous with severe stenosis because your heart cannot pump enough blood. Always discuss exercise plans with your cardiologist based on your specific severity level.
For severe symptomatic stenosis, valve replacement is the definitive treatment. You may choose traditional open-heart surgery or a less invasive transcatheter procedure. Some patients get temporary relief from balloon valvuloplasty, but the valve usually narrows again. The best approach depends on your age, overall health, and valve anatomy.
Eating a heart-healthy diet low in saturated fat helps reduce further calcification. Managing blood pressure and cholesterol with medication if needed is important. Maintaining a healthy weight and avoiding smoking protect your heart. While these steps may slow progression, they cannot stop or reverse existing valve damage.
Calcific stenosis develops from age-related wear and calcium buildup on the valve. Rheumatic valve disease results from untreated strep throat infection that damages the heart. Calcific stenosis is much more common in developed countries today. Both conditions narrow the valve, but calcific stenosis usually appears in older adults while rheumatic disease affects younger people.
Statins lower cholesterol and may slow valve calcification progression in some people. Research shows mixed results, with some studies finding modest benefit. Statins are often prescribed to reduce overall cardiovascular risk rather than specifically targeting the valve. Your doctor will consider your complete heart health profile when deciding on statin therapy.