Aortic Stenosis Signs and Symptoms

Most patients with aortic stenosis develop one or more of these three classic symptoms: shortness of breath, loss of consciousness, and chest pain. Thickening of the walls of the left ventricle causes the ventricle to become stiff and unable to relax between contractions. When this happens, the pressure in the left ventricle rises and blood can "back up" into the lungs, interfering with normal absorption of oxygen from the lungs into the bloodstream. This may cause shortness of breath, which worsens as the left ventricle becomes increasingly impaired.

The aortic valve may become so constricted (stenotic) that it can open only slightly, drastically reducing the amount of blood that flows into the aorta and throughout the body. In some cases, the flow of oxygen-rich blood to the brain may not be enough to sustain normal brain function. When this occurs, patients may briefly lose consciousness, or pass out. Losing consciousness is called syncope.

Patients with aortic stenosis may also experience chest pain, pressure, or discomfort (called angina or angina pectoris), caused by an insufficient supply of oxygen to the heart. As the left ventricle thickens and works harder to expel blood through the stenotic aortic valve, its demand for oxygen increases.

To compound the problem, aortic stenosis reduces blood flow to the heart itself as well as to the rest of the body (the coronary arteries and other arteries of the body originate from the aorta). Thus, while the heart's demand for oxygen increases, its supply of oxygen-rich blood decreases, causing angina.

Aortic Stenosis Complication

The turbulent blood flow across the stenotic aortic valve predisposes the valve to infection. Infection of a heart valve is called endocarditis. Patients with aortic stenosis who are to undergo a dental or medical procedure in which there is the risk for bacteria to enter the blood should inform their dentist or physician of their condition. These patients may require an antibiotic prior to undergoing the procedure. Administering antibiotics to prevent valve infection is called endocarditis prophylaxis.

Endocarditis prophylaxis may be administered prior to the following:

  • Certain dental procedures (e.g., extractions, cleaning)
  • Certain invasive imaging procedures (e.g., bladder cystoscopy)
  • Surgery

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 30 Jun 2000

Last Modified: 01 Sep 2015