How aortic valve stenosis causes symptoms

Aortic valve stenosis can cause the following symptoms.

Chest pain (angina)

Angina occurs when your heart does not get enough oxygen-rich blood through the coronary arteries, which are the vessels that supply the heart with blood. Your heart hurts because it is starved for oxygen, a condition called myocardial ischemia. Because your heart needs more blood when you are physically active, you will typically experience angina during exercise or other physical activities.

About two-thirds of people who have severe aortic valve stenosis experience angina. About half of those people also have coronary artery disease (CAD), a narrowing of the coronary arteries that is caused by the buildup of hard plaque (atherosclerosis). Angina may be worse in people who have both aortic valve stenosis and CAD and is one of the ways that CAD can make aortic valve stenosis more dangerous.

Fainting (syncope)

In the same way that aortic valve stenosis prevents enough blood from reaching the heart, it can also prevent your heart from pumping enough blood to your brain. Without enough blood, your brain cannot maintain consciousness. Before actually blacking out or fainting, you may experience dizziness or "graying out," which is a brief blurring of vision. Although fainting occurs while you are exerting yourself, you may also experience it when you are at rest, which can result from an irregular heartbeat that comes and goes in association with advancing heart failure.

The irregular contraction of your heart can occur in your ventricle or your atrium, either of which can significantly affect your heart's ability to pump enough blood. This irregular heartbeat generally returns to normal on its own, at which point you will recover from the syncope.

Shortness of breath (dyspnea)

Shortness of breath is actually a symptom of heart failure that occurs when blood begins to back up into the stiff or failing left ventricle. This blood raises the pressure in the vessels that carry blood between the heart and the lungs (pulmonary hypertension). And extra fluid builds up in the lungs (pulmonary congestion). The extra fluid interferes with the exchange of oxygen for carbon dioxide in the blood.

Shortness of breath is most common during physical exertion. But shortness of breath can also occur suddenly during your sleep (paroxysmal nocturnal dyspnea). You may also have difficulty breathing when you are lying flat (orthopnea).

Other symptoms of heart failure

Although dyspnea is generally an indication of significant heart failure, other symptoms of heart failure can occur in the most advanced stages of aortic valve stenosis. These include pulmonary edema, which is fluid in the lungs that causes coughing, wheezing, and difficulty breathing as well as fatigue and physical weakness.

Last Updated: November 4, 2009

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