Aortic Stenosis Child

Overview

Definition

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
heart anatomy
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Causes

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:

  • 1 cusp that can not open as fully as 3 cusps
  • 2 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.

Risk Factors

Factors that may increase your child's chance of AS include:

  • Family members with congenital valvular heart diseases
  • Rheumatic fever—which can occur after a strep infection
  • Bacterial endocarditis—infection of the heart

SymptomsandDiagnosis

Symptoms

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

Diagnosis

You will be asked 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:

  • Chest x-ray
  • Echocardiogram
  • Rarely, cardiac catheterization

Treatments

Treatment

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:

Lifestyle Changes

If your child has moderate to severe AS, your child may need to avoid strenuous physical activity., such as playing competitive sports.

Medications

If necessary, your child may be given medication to help prevent heart failure.

Surgery

Severe AS may require surgery. Procedures include:

  • Balloon valvuloplasty—A balloon device is passed through the arteries to open or enlarge the aortic valve. Since the valve can become blocked again, surgery may need to be repeated.
  • Aortic valve replacement—Replacement of a defective heart valve.

Prevention

There are no current guidelines to prevent congenital AS.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Stenosis, Aortic—Child; AS—Child)

RESOURCES

American Heart Association http://www.heart.org 

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov 

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca 

Canadian Society for Vascular Surgery http://www.canadianvascular.ca 

References

Aortic stenosis in children. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/aortic-valve-stenosis. Accessed June 6, 2016.

Aortic (valve) stenois in infants and children. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/a/avs/. Accessed June 6, 2016.

Aortic stenosis. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T114195/Aortic-stenosis . Updated August 19, 2016. Accessed September 29, 2016.