Aortic Stenosis—Child

(Stenosis, Aortic—Child; AS—Child)

Definition

Aortic stenosis (AS) is a narrowing of the aortic valve. This valve controls the flow of blood from the heart to a large artery called the aorta. The aorta carries the blood to the rest of the body.Aortic stenosis can interfere or block the flow of blood from the heart to the rest of the body. It could also cause a back-up of blood into the heart and lungs. AS can range from mild to severe.
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Causes

The aortic valve is normally made up of three cusps that open and close together. In babies, AS is caused by a birth defect of the aortic valve that may result in:
  • One cusp that can not open as fully as three cusps
  • Two cusps that are damaged
  • Cusps that are partly closed or do not open correctly due to thickness
The aortic valve can also be damaged by infection or injury to the valve.

Risk Factors

Factors that increase your child's chance of developing AS include:Tell the doctor if your child has any of these risk factors.

Symptoms

Mild AS may not cause any symptoms. More severe AS may cause:
  • Extreme fatigue after exercise or exertion
  • Fainting with exercise or exertion
  • Pain, squeezing, pressure, or tightness of the chest, usually occurring with exertion
  • Sensation of rapid or irregular heartbeat (palpitations)
  • Shortness of breath
  • Dizziness with exertion
In rare cases, AS can cause:
  • Abnormal heart rhythms ( arrhythmia )
  • Sudden death with no previous symptoms

Diagnosis

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. The doctor may be alerted of AS by the following:
  • Abnormal chest sounds, such as a heart murmur or click
  • Noticeable chest heave or vibration when the doctor's hand is held over your child’s heart
To confirm the diagnosis, tests may include:

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Treatment

Mild AS will be monitored for any changes or complication. Treatment may not be needed right away.Treatment options for moderate to severe AS may include:

Lifestyle Changes

If your child has moderate to severe AS, your child may need to avoid strenuous physical activity. For example, your child will not be able to play competitive sports.

Medicines

If necessary, your child may be given medication to help prevent heart failure . In certain cases, your child may need to take antibiotics before dental appointments or surgical procedures. This is to prevent an infection that could affect his heart.

Surgery

Severe AS may require surgery. Options include:
  • Balloon valvuloplasty —A balloon device is passed through the arteries to open or enlarge the aortic valve. This may provide relief of symptoms. Since the valve can become blocked again, this surgery may need to be repeated.
  • Aortic valve replacement —This is the surgical replacement of a defective heart valve.

Prevention

Congenital AS cannot be prevented.

RESOURCES

American Heart Association
http://www.americanheart.org/

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov/

CANADIAN RESOURCES

Canadian Cardiovascular Society
http://www.ccs.ca/

Canadian Society for Vascular Surgery
http://www.canadianvascular.ca/

References

Aortic stenosis. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site481/mainpageS481P0.html. Accessed June 24, 2013.

Aortic stenois. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/heart-encyclopedia/anomalies/avs.htm. Accessed June 24, 2013.

Aortic stenosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 20, 2013. Accessed June 24, 2013.

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