​Aortic Stenosis

Aortic stenosis is the narrowing of the aorta. Aorta valve is a one-way valve or the main artery, which carries oxygenated blood from the heart to the rest of the body. 

Aortic stenosis prevents the valve from opening fully hence reducing the blood supply from the heart to the rest of the body. The heart is forced to work harder which can eventually lead to weakening of the heart muscles. Aortic stenosis can occur due to a variety of reasons. These include:

  • Congenital birth defect in which the child is born with one (unicuspid), two (bicuspid) or four (quadricuspid) leaflets (which are ​​​flaps of tissue) instead of the standard three leaflets. The exact cause of this birth deformity is unknown. Moreover your child may not experience any problems until adulthood but should get regular check-ups by a doctor to look for signs of narrowing

  • Calcification of the aortic valve in which calcium mineral, present in the blood, begins to accumulate in the valve. This is most common in adults and rarely found in children

  • Rheumatic fever can develop aortic stenosis in children, though rarely

​Aortic stenosis can also occur spontaneously without any known reason or as part of a group of abnormalities that affect the left ventricle.

Most children won’t show any symptoms of aortic stenosis in its early stages. The doctor may hear a murmur while listening to your child’s heart during routine check-ups.

As the disease advances, your child may experience:

  • Fainting

  • Shortness of breath or difficulty in breathing

  • Chest pains

  • Palpations

  • Fatigue

  • Dizziness during or after vigorous physical activity

In infants, you may notice that your child is:

  • Pale

  • Too sleepy to feed properly​

​See on one of our doctors at the Children's Hospital Service Line at The Aga Khan University Hospital immediately if you notice your child is experiencing the above mentioned symptoms.​

​Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​

The doctor may notice a heart murmur in your child during routine check-up. Heart murmur can be produced by various diseases linked to the heart. It occurs as the blood forces through the narrowed valves. If the doctor suspects an aortic stenosis in your child, they may ask you to get a series of tests conducted on your child to confirm the diagnosis and determine the severity of the disorder. These tests include:

  • Echocardiogram in which sound waves, directed at the heart from a device (transducer) placed on the chest, are used to produce images of the heart. The doctor studies the images to see if there is any abnormality in the heart or heart valves. This is a primary test to determine aortic stenosis and its severity 

  • Electrocardiogram (ECG) in which the electrical activity of the heart is recorded to detect if the left ventricle is thickened or enlarged; which can happen due to aortic stenosis

  • Chest X-ray to detect any enlargement of the left ventricle, calcium deposits in the aorta, and the condition of the lungs as aortic stenosis can lead to blood and fluid backing up in the lungs, causing congestion

  • Cardiac catheterization in which a thin tube (catheter) is inserted in the arm or groin and threaded up to an artery in the heart. This is done to inject a dye in the arteries which highlights the arteries on an X-ray. This test shows any blockages in arteries that indicates aortic stenosis. This procedure is performed if the non-invasive tests fail to provide adequate information regarding the type or severity of the heart’s disorder

  • Exercise catheterization which evaluates the heart’s activity during exercise. This is done if the doctor suspects the presence of severe aortic stenosis that does not show any symptoms

  • Computerized Tomography (CT) scan, which uses a series of X-rays, and Magnetic Resonance Imaging (MRI) , which uses magnets and radio waves, to generate detailed images of the heart and heart valves​

The treatment plan devised for your child will depend on their age, general health, severity of the disorder and of course, your personal preference. In case of mild to moderate aortic stenosis, your child may not require any treatment right away but they would be monitored closely by their doctor. Routine check-ups may include physical examination and echocardiogram. Further treatment options include:
  • Medications to alleviate the symptoms, such as increased heart rate, fluid accumulation, increased blood pressure, or disturbed heart rhythm. There are no medications available to reverse the aortic stenosis

  • Balloon valvuloplasty in which a soft thin tube (catheter) tipped with balloon is inserted into a blood vessel in the groin and threaded up to the heart, into the narrowed aortic valve. The balloon is inflated to push open the valve and improve blood flow. The catheter is removed after deflating the balloon. This procedure is more suitable for infants and children as compared to adults

  • Aortic valve replacement which is a surgical procedure undertaken in severe cases. This procedure is carried out to replace the narrowed aortic valve with either a mechanical valve or a donor valve. Your child will be required to stay in the hospital for up to 10 days. Aortic valve replacement has an excellent success rate and children who undergo this procedure can enjoy a normal, healthy life.     ​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

​The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

​Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​



The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​