Aortic Stenosis—Child
Condition
(Stenosis, Aortic—Child; AS—Child)
Definition
Aortic stenosis (AS) is a narrowing of the aortic valve opening. This valve controls the flow of blood from the heart to a large artery called the aorta. This artery carries blood from the heart to the rest of body.
AS makes it hard for blood to flow out of the heart. It can lower the amount of blood that goes to the body and cause a backup of blood into the heart. This backup can raise pressure in the heart and lungs. AS can range from mild to severe.
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Causes
The aortic valve is made up of three cusps that open and close together. In babies, AS is caused by a birth defect that may result in:
- One cusp that cannot open as fully as three cusps
- Two cusps that are damaged
- Cusps that are partly closed or do not open the right way due to thickness
The valve can also be damaged by infection.
Risk Factors
Things that may raise a child's risk of AS are:
- Having other family members who have congenital valvular heart diseases
- Rheumatic fever—which can happen after a strep infection
- Bacterial endocarditis—infection of the heart
Symptoms
Mild AS may not cause any problems. More severe AS may cause:
- Severe lack of energy after activity
- Lightheadedness with activity
- Fainting with activity
- Rapid or irregular heartbeat
- Shortness of breath
- Pain, squeezing, pressure, or tightness of the chest, usually with activity
Rarely, AS may cause heart rhythm problems and sudden death.
Diagnosis
The doctor will ask about your child’s symptoms and health history. A physical exam will be done. It will focus on the chest and heart.
Pictures may be taken to view the heart and structures around it. This can be done with:
Treatment
Mild AS will be monitored for any changes or problems. Treatment may not be needed right away.
Choices for moderate to severe AS are:
- Lifestyle changes, such as avoiding strenuous activities
- Medicine to lower stress on the heart and lower the risk of heart failure
Some children may need surgery. Choices are:
- Balloon valvuloplasty to open the aortic valve or make it bigger
- Aortic valve replacement to replace a defective heart valve
Prevention
There are no known guidelines to prevent AS.
American Heart Association
National Heart, Lung, and Blood Institute
CANADIAN RESOURCES:
Canadian Cardiovascular Society
Canadian Society for Vascular Surgery
American Heart Association
National Heart, Lung, and Blood Institute
CANADIAN RESOURCES:
Canadian Cardiovascular Society
Canadian Society for Vascular Surgery
References
- Aortic stenosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/aortic-stenosis.
- Aortic stenosis in children. Boston Children's Hospital website. Available at: https://www.childrenshospital.org/conditions/conditions/aortic-valve-stenosis.
- Aortic (valve) stenosis in infants and children. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/a/avs.
- Baumgartner H, Falk V, et al; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017 Sep 21;38(36):2739-2791.
Contributors
- Kari Kuenn, MD
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