What are the symptoms of aortic valve stenosis?

Joseph E. Bavaria, MD
Thoracic Surgery (Cardiothoracic Vascular)
When the valve’s leaflets don’t fully open, your heart must work harder to push blood through the narrowed aortic valve to your body. As a result, the narrowed valve allows less oxygen-rich blood to flow from the lungs to the brain and rest of the body, which may cause symptoms like severe shortness of breath and extreme fatigue.
In aortic stenosis, symptoms are a paramount guide to prognosis and for the need for valve replacement. Three "red flag" symptoms that portend poor prognosis without intervention in aortic stenosis are chest discomfort (angina), shortness of breath on exertion due to heart failure, and lightheadedness or passing out (syncope).

Both children and adults can have aortic stenosis. Often there are no signs of the disease until you are age 40 or older. The most common signs and symptoms of aortic stenosis are:

  • chest pain
  • dizziness
  • fainting
  • shortness of breath during exercise or activities like climbing stairs
Other symptoms may include:
  • fast and irregular heart beat
  • fatigue (feeling tired more than the usual)
  • heart murmur (abnormal heart sound) when healthcare providers listen to your heartbeat
  • trouble breathing (especially when lying flat or with just one pillow), or being awakened from sleep due to trouble breathing
    Abdul J. Tajik, MD
    Cardiology (Cardiovascular Disease)
    The progression of aortic valve disease (aortic stenosis) varies from person to person. The disease may be silent for many years and, in some cases, never cause problems. A murmur may be the first sign that there is a defect in the aortic valve.

    One or more of the following symptoms can occur in patients with aortic stenosis:

    • Shortness of breath: This can occur at rest or with activity. It can limit a patient’s ability to tolerate exercise. This occurs when adequate amounts of oxygen-rich blood do not reach the coronary arteries or as blood backs up into the lungs.

    • Chest pain or pressure referred to as angina: Chest pain or pressure most often occurs with or right after activity and improves with rest. The coronary arteries supply blood to the heart muscle. They branch off from the aorta just above the aortic valve. If enough blood does not get to the coronary arteries, the heart muscle is deprived of oxygen-rich blood and chest pain develops. In addition, the heart muscle can become thickened in response to the high pressure, but the arteries supplying blood to the area remain unchanged. Therefore, the muscle does not get an adequate supply of blood, resulting in chest pain.

    • Fatigue: Due to the gradual onset, fatigue is often not recognized early on or it is thought to be related to other factors.

    • Palpitations: These are uncomfortable sensations in the chest that feel like the heart is pounding or racing. These sensations can be a result of an abnormal heart rhythm and may be associated with sweating, shortness of breath or chest pain. The episodes may last only seconds or continue for long periods of time.

    • Lightheadedness or fainting spells (also called syncope): This can occur when changing positions or with activity. These symptoms usually occur because the brain is not getting enough blood flow due to an obstruction in the heart or an abnormal heart rhythm. If you experience a fainting spell, you should report it to your doctor immediately.

    For patients who have mild or moderate aortic stenosis, there may be no symptoms. In severe aortic stenosis, symptoms may include:

    - Fatigue (tired feeling) or lethargy (not very active)
    - Shortness of breath or trouble breathing (including very fast breathing) with activity
    - Fainting
    - Chest pain
    - Abnormal heart rhythm (arrhythmias)
    - For infants: poor feeding and/or poor weight gain

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    Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.