Aortic Valve Stenosis - Diagnosis & Treatment

Symptoms & Causes Diagnosis & Treatment Our Expertise & Doctors

How is aortic valve stenosis diagnosed?

Your doctor will typically begin with a physical examination, listening for a distinctive heart murmur that often signals aortic valve stenosis before symptoms appear. If stenosis is suspected, further tests may include:

Echocardiogram: The primary diagnostic tool. Sound waves create detailed images of the valve, allowing doctors to measure how narrowed it is and how well the heart is functioning.
Electrocardiogram (ECG): Records the heart's electrical activity and can reveal signs of strain on the heart muscle.
Chest X-ray: May show an enlarged heart or calcium deposits on the valve.
Cardiac catheterisation: An invasive test that directly measures pressure within the heart chambers; typically used when non-invasive results are inconclusive or when planning treatment.
CT or cardiac MRI: May be used to assess the valve and surrounding structures in more detail, particularly before a procedure.

What does an echocardiogram show in aortic valve stenosis?

An echocardiogram measures how well the aortic valve opens and how fast blood flows through it. These measurements – including the valve area and pressure gradient – are what doctors use to classify the condition as mild, moderate, or severe, and to track how it changes over time.

How is aortic valve stenosis treated?

Treatment depends on the severity of the stenosis, whether symptoms are present, and the patient's overall health. Options range from monitoring to valve replacement.

Monitoring and medical management

For patients with mild to moderate aortic valve stenosis and no symptoms, treatment usually involves regular monitoring with echocardiograms rather than immediate intervention. There is currently no medication that can reverse or slow the narrowing of the valve itself, though medications may be used to manage related conditions such as high blood pressure.

Surgical aortic valve replacement (SAVR)

Open-heart surgery to replace the damaged valve with a mechanical or biological (tissue) valve. This has long been the standard treatment for severe aortic valve stenosis, particularly in patients who are otherwise fit for surgery, and offers durable, long-term results.

Transcatheter aortic valve implantation (TAVI)

TAVI is a minimally invasive procedure that places a new valve inside the diseased one via a catheter, typically inserted through an artery in the leg, without the need for open-heart surgery. It was originally developed for patients at high surgical risk, but is increasingly used across a broader range of patients with severe aortic valve stenosis.

As TAVI does not require opening the chest, it is associated with a less invasive recovery process compared to open surgery, making it a valuable option for elderly patients or those with other medical conditions that increase surgical risk.

Balloon aortic valvuloplasty

A catheter-based procedure that uses a balloon to widen the narrowed valve. Because the improvement tends to be temporary, it is generally used as a bridge to a more definitive treatment, or in select cases such as children and young adults with congenital stenosis.

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