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Signs and Symptoms

When symptoms occur, they often start during times of labor and effort and include:

  • Shortness of breath
  • Chest pain (angina)
  • Passing out (syncope)
  • Fatigue (feeling tired)
  • Reduced ability to exercise or be active
  • Sudden death

Once symptoms begin, they often get worse. If not diagnosed and treated, they can cause severe heart problems.

Over time, if the heart muscle gets very weak and there is heart failure, symptoms can also include swelling in the ankles, shortness of breath with exertion and when resting, and an inability to lie flat.

There are three main causes of aortic stenosis.

The first and most common cause is buildup of calcium on a normal aortic valve that occurs as patients get older.

Second, about 2% of people are born with an aortic valve with an abnormal valve structure. Normal aortic valves have three leaflets, also called cusps. In a small portion of the population, the aortic valve has two cusps (bicuspid aortic valve) and, more rarely, one or four cusps. In these cases, the blood flows more roughly over the valve and causes calcium buildup and narrowing of the valve (stenosis) at an earlier age (50 to 60 years old, instead of 70 to 80 years old).

Third, a less likely cause of aortic stenosis is inflammation caused by rheumatic fever, a condition that is more common in underdeveloped countries.