Congenital
Aortic Valve Stenosis
What
is it?
Aortic valve stenosis is a
narrowing of the aortic valve. The aortic valve
opens to allow blood to flow from the left
ventricle of the heart to the aorta, and then to
the body. Because
the opening is narrowed, the left ventricle has to
pump extra hard to propel blood through the valve.
This causes the left ventricle to become enlarged. The
valve may also have two leaflets, instead of
three, or may have an abnormal funnel shape. The narrowed valve may not be a problem during infancy, but
becomes one as the child grows and the heart
cannot keep up with the body’s demand for blood.
“Congenital” aortic valve stenosis means the
condition is present at birth.
Who
gets it?
Males are four times more
likely to get this disease. Aortic valve stenosis
accounts for approximately 7% of all cases of
congenital heart disease.
What
causes it?
Aortic valve stenosis can run
in families or may be due to something that
happened to the fetus during pregnancy.
Unless it is severe, the
condition is often not detected until later in
life.
What
are the symptoms?
Most
children with aortic valve stenosis have no
symptoms, so it’s difficult to detect.
In general, many patients will be easily
fatigued, but show no other symptoms until their
thirties to fifties.
A small number of children may be prone to
dizziness and fainting (syncope) within the first
ten years of life. If
the obstruction is great, infants may suffer from
severe heart failure. Sudden
death is uncommon, but possible. Adolescents
with hypertrophic cardiomyopathy, a type of aortic
stenosis where the left ventricle is noticeably
enlarged, have the greatest risk of sudden heart
failure.
How
is it diagnosed?
Children
with aortic valve stenosis usually have a heart
murmur that can be heard with a stethoscope.
A doctor can also detect pulse
abnormalities and will see irregularities on an
electrocardiogram (ECG).
A chest x-ray may also show an enlarged
left ventricle.
An echocardiogram may also be ordered.
This technique uses ultrasound waves to
create an image of the heart and its function.
In cases where severe blockage is suspected
and surgery most likely, doctors may do a left
heart cardiac catheritization.
In this procedure, a thin tube (catheter)
is inserted through an artery and moved into the
heart chambers.
This procedure will measure the pressure
difference between the
left ventricle and the aorta.
What
is the treatment?
Children
with aortic valve stenosis require close medical
supervision and should undergo yearly exercise
testing after the age of six. Most children with mild to moderate aortic valve stenosis can
engage in normal physical activities. Surgery
is only performed in cases of severe obstruction. The most common treatments are surgical valve repair and
balloon valvuloplasty.
A balloon-tipped catheter is inserted into
the aortic valve.
The balloon is then inflated to expand the
valve opening.
Some forms of aortic valve stenosis require
medical management with beta-blockers or calcium
channel blockers.
Self-care
tips
If your child has been
diagnosed with aortic valve stenosis, follow your
doctor’s recommendations for treatment and
physical activity.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
