One of the most common heart valve diseases, aortic stenosis can affect both children and adults. In children, the characteristic narrowing of the aortic valve can be caused by a genetic condition, rheumatic fever or uncontrolled artery disease. In older adults, deposits of calcium on the valve’s leaflets can alter the valve’s function. Although aortic stenosis can become serious, early diagnosis and treatment to repair or replace the valve can help your child enjoy a full life.

Wellness & Prevention

Each minute, your child’s heart beats dozens of times, pushing blood through four chambers to and from the body. In the upper chamber, the aortic valve connects the heart to the aorta and opens and shuts to allow blood to flow.

Aortic stenosis is diagnosed when the aortic valve is too narrow or can’t fully open and restricts the amount of blood that can pass through at one time. To compensate, the left ventricle works harder to pump blood through the smaller valve. As a result, the ventricle can thicken and become enlarged.

Children who have aortic stenosis have a higher chance of experiencing an infection in the lining of the heart, a swollen aorta that can increase the risk of an aneurysm or a tear in the aorta and a lack of oxygenated blood in the coronary arteries. Without treatment, the left ventricle may stop working and the child may suffer congestive heart failure.

The best way to prevent aortic stenosis caused by external factors is to pay close attention to your child’s health, especially if your child has a strep infection that becomes rheumatic fever. Congenital aortic stenosis is also more likely to occur in boys than girls.

Children with mild or moderate aortic stenosis may not have any symptoms. Babies who have aortic stenosis may have trouble feeding or poor growth. Severe or critical aortic stenosis symptoms in older children include:

  • Fatigue
  • Low blood pressure
  • Passing out
  • Shortness of breath
  • Dizziness with exertion
  • Irregular heartbeats or palpitations
  • Chest pain
  • Tiring easily during exercise
  • A bluish color at the lips or fingers

Diagnosis

Your child’s doctor is often the first medical professional to notice aortic stenosis during a physical exam. She may have heard extra noise caused by the obstructed blood flow and recommend that your child see a pediatric cardiologist. There are several different ways that cardiologists diagnosis aortic stenosis.

  • Chest X-ray and cardiac MRI: X-rays and cardiac MRIs produce an image of the heart, lungs, tissue and bones in the child’s chest
  • Electrocardiogram (ECG or EKG): Electrocardiograms are used to record the electrical activity in the heart. An ECG can show abnormal rhythms and stress on the heart. An exercise ECG can also be performed to see how the child’s heart works while exercising on a treadmill or stationary bike.
  • Echocardiogram: Using an ultrasound, an echocardiogram creates an image of the heart and assesses the structure and function of the heart.
  • Cardiac catheterization: A tiny catheter can be inserted through a larger blood vessel, often in the groin, and threaded into the heart to take blood pressure and oxygen measurements in the aorta and throughout the heart.

Treatments

Treatment plans can vary based on your child’s age, health, medical history, the level of aortic stenosis and the prognosis.

Mild to moderate aortic stenosis typically does not require treatment but should be monitored through regular visits with a cardiologist to ensure the condition doesn’t worsen or start affecting the heart.

Severe to critical aortic stenosis can be treated first with medication to help improve function until valve repair or replacement can be scheduled at a pediatric heart center. Treatment options include:

  • Balloon dilation: Using the cardiac catheterization procedure, a tiny tube is again guide through the blood vessels to the heart where a balloon is inflated in the valve stretching it open.
  • Valvotomy: Your pediatric cardiologist may surgically release the scar tissue preventing the aortic valve from opening.
  • Valve replacement: The aortic valve can be surgically replaced with a biological valve made from animal tissue or mechanical valve made from carbon fibers. A portion of a pulmonary artery, either from the child or a donor, or an aortic valve from a donor can also be used to replace the valve and part of the aorta.

Aftercare

After treatment, your child will need time to rest and recuperate and at home and activities may be limited. Once your pediatric cardiologist approves, your child should be able to resume normal activities. Follow up treatment may be needed as your child grows and ongoing medication may be recommended to prevent rejection or blood clots on artificial valves.