Valvular Stenosis

Valvular Stenosis 101

Valvular stenosis occurs when one or more of the heart valves become stiff or fused. The result is a narrower opening through which the blood can flow. The heart must work harder to pump blood through the smaller than normal opening. Some cases of valvular stenosis can lead to heart failure and some cases are mild with few symptoms. There are four types of valvular stenosis: aortic stenosis, mitral stenosis, pulmonic stenosis, and tricuspid stenosis. Valvular stenosis is congenital, caused by age, or a result of childhood rheumatic fever.

In the case of congenital aortic stenosis, a person is born with only 1 or 2 cusps or flaps that make up the aortic valve. A healthy aortic valve has three cusps. The blood flow through an aortic valve that is missing cusps is chaotic and turbulent, causing the existing cusps to scar and calcify. With congenital stenosis of the mitral, pulmonary, and tricuspid valves, the resulting stiffness or blockage is due to other pathologic processes such as lesions, or fusing together. 

When valvular stenosis is caused by age, it usually occurs in people who are 65 and older. With age, the protein collagen in the tissues of the valve flaps begin to break down and calcium can build up. 

Rheumatic fever is an inflammatory disease that attacks the heart and lungs, among other things. It is very rare in the United States. However, in other parts of the world, it is a common culprit for diseased heart valves. It typically occurs in children between the ages of 6 and 15.

Pulmonary stenosis typically occurs only in children as a congenital condition and is not acquired later in life.  It is usually treated in childhood, although some children with pulmonary stenosis continue to need treatment as adults. 

Tricuspid stenosis is not common in the United States. It occurs in only about 1% of the population.  Like pulmonary stenosis, it is typically only congenital or rheumatic. However, it can also be caused by systemic lupus erythematosus, endomyocardial fibrosis, carcinoid syndrome, and endocarditis.

Symptoms of valvular stenosis can include:

• Fatigue
• Breathlessness
• Chest pain
• Fainting
• Swelling in the abdomen
• Heart palpitations
• Atrial fibrillation
• Coughing up blood
• Bluish coloring in infants
• Slow weight gain in infants

In cases that are mild, no treatment is necessary, but may require frequent monitoring by a doctor.  Treatment for valvular stenosis can include:

• Medication
• Abstaining from sports and other strenuous aerobic activities 
• Valve repair surgery
• Valve replacement surgery

With the exception of some children, the symptoms and severity of valvular stenosis occur over a long period of time. They do not develop suddenly. If you’d like to learn more about valvular stenosis or heart health, please contact us at Lawnwood Regional Medical Center and Heart Institute. Call 1-800-382-3522 for answers to your questions and free referrals to specialists in the Treasure Coast area.