Heart and Blood Conditions
What is aortic stenosis?
Aortic stenosis (pronounced a-OR-tik sten-OH-sis) is the narrowing or blocking of the heart’s aorta. The aorta is the artery that carries oxygen-rich (red) blood from the heart to the body.
Stenosis can happen above or below the aortic valve, or the valve itself may have narrowed.
If the aorta or valve is narrowed, the left ventricle has to pump harder to push blood through it. To perform the extra work, the muscular wall of the ventricle gets thicker.
How common is aortic stenosis?
About 4 in 1,000 babies are born with aortic stenosis. It’s about 4 times more common in boys than in girls.
What causes aortic stenosis?
Some children are born with aortic stenosis, and some children begin life with a normal aorta and valve and then develop aortic stenosis later on. Although the causes of aortic stenosis aren’t completely clear, 1 known cause is rheumatic fever, a problem with inflammation that can develop after an infection with Streptococcus bacteria.
Aortic Stenosis at Seattle Children’s
Seattle Children’s Heart Center is one of the best pediatric cardiology programs in the United States and is the top-ranked program in the Northwest, according to U.S. News & World Report. With more than 40 pediatric cardiologists, we have experience diagnosing and treating every kind of heart problem.
Our heart team has treated many children with aortic stenosis. We have extensive experience with the treatment these patients may require, including cardiac catheterization and surgery. We also have a pediatric cardiac anesthesia team and a Cardiac Intensive Care Unit ready to care for children who undergo heart surgery.
Seattle Children’s has been treating children since 1907. Our team members are trained in their fields and in meeting the unique needs of children. For example, the doctors who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.
We have a special Adult Congenital Heart Disease Program to transition your child to adult care when they’re ready. Seattle Children’s and the University of Washington developed this program to help with care throughout your child’s life.
When you come to Seattle Children’s, a team of people will take care of your child in a child-focused, healing environment. Along with your child’s cardiologist, you are connected with neonatologists, pulmonologists (lung doctors), nurses, child life specialists, social workers and others, if their expertise is needed. We work together to meet all of your child’s health needs and help your family through this experience.
Read more about the supportive care we offer.
Symptoms of Aortic Stenosis
Most children with aortic stenosis do not have any symptoms. They may have no noticeable problems unless the stenosis gets worse.
If children do have symptoms, they may include:
- Feeling short of breath when active
- Having pain, pressure or tightness in their chest
- Fainting or feeling weak or dizzy when active
- Having palpitations
Babies born with severe aortic stenosis may have to work hard to breathe, have poor appetite or trouble feeding and failure to thrive.
They may also show signs of shock because their heart cannot pump enough blood to the rest of their body. Signs of cardiogenic shock include:
- Less frequent urination (peeing)
- Cool limbs (arms and legs)
- Increased heart rate
- Poor feeding
- Rapid breathing
- Lethargy (lack of energy)
- Mottled skin (discolored skin)
Diagnosing Aortic Stenosis
To diagnose aortic stenosis, your doctor will examine your child, use a stethoscope to listen to their heart and check their blood pressure. Sometimes, doctors find aortic stenosis after hearing a heart murmur in a child who appears well.
The doctor will ask for details about any symptoms your child has, their health history and your family health history.
If your child has aortic stenosis, an echocardiogram will be done to evaluate the stenosis and to see how their heart works.
Your child may need other tests that provide more information about their heart. These include:
Treating Aortic Stenosis
Not all children with aortic stenosis need treatment to fix their aorta or valve. It depends on how severe their condition is. But all children with aortic stenosis need lifelong care to monitor their condition in case it gets worse.
Some children with aortic stenosis need treatment immediately because their heart cannot deliver enough blood and oxygen to the rest of their body.
Aortic Stenosis Treatment Options
Treatment may be done in the cardiac catheterization lab using a balloon procedure. A balloon is inserted across the valve. When the balloon is inflated, the valve is stretched open. Then the balloon is removed. This is called balloon valvuloplasty.
Some children need surgery to replace their aortic valve with an artificial valve. In some cases the child’s own pulmonary valve can be used to replace the damaged aortic valve.
Transitioning to Adult Care
To meet your child’s long-term healthcare needs, we have a special Adult Congenital Heart Disease Program to transition your child to adult care when they’re ready.
Contact the Heart Center at 206-987-2515 to request an appointment, a second opinion or more information.
Providers, see how to refer a patient.