When the stethoscope comes out at your doctor’s office, there’s about a one in 10 chance it’ll pick up a heart murmur — a sign that blood is moving irregularly through your heart. The older you are, the greater the likelihood it’s caused by aortic stenosis.
Aortic stenosis is a common heart problem for older adults.
Aortic valve stenosis — or simply, aortic stenosis — is a narrowing of the aortic valve. When it becomes severe, it can lead to heart failure.
For most of us, this condition develops due to age-related wear and tear and calcium buildup on the aortic valve. In fact, it’s estimated that about one out of 50 Americans over the age of 65 have some form of aortic stenosis. By age 75, that number rises to more than one in 10.
Because it’s often undiagnosed in early stages, “the true prevalence may be even higher than these estimations,” says Dr. Carreras.
A heart murmur is often the first sign of aortic stenosis.
If you have aortic stenosis, you need to be under a cardiologist’s care. But it can take years to develop obvious symptoms, like chest pain and shortness of breath. By that point, you risk serious heart issues.
Heart murmurs act as an early warning system. If your physician hears something unusual with a simple stethoscope exam, they’ll refer you to a cardiologist for a specific diagnosis and care.
“This is yet another reason it’s important for everyone to see a doctor regularly,” says Dr. Carreras.
Ultimately, the only treatment is to replace the aortic valve.
If your heart murmur is indeed caused by aortic stenosis, there’s good news and there’s bad news.
The good: “Until the valve has reached a severe level, we will simply evaluate the valve with regular ultrasounds, and patients should comfortably live their normal lives,” says Dr. Carreras. That can be years or even decades.
The bad: Aortic stenosis can’t be treated or slowed through medications. This means that, at a certain point, most people need to have their valve replaced, either through open-heart surgery or a minimally invasive procedure called transcatheter aortic valve replacement (TAVR). Your doctor will determine which procedure is right for you.
“The most important thing is to not wait too long to have the valve replaced,” says Dr. Carreras.
How will you know when it’s time to have a valve replacement?
“It’s extremely important to follow up regularly with a cardiologist,” says Dr. Carreras.
They’ll keep an eye on how much your valve is (or isn’t) narrowing over time, and recommend when to do something about it.
Worried that you’re too old for the procedure? Don’t be.
“Valve replacement, in particular the minimally invasive TAVR procedure, is very safe and effective with a relatively speedy recovery,” says Dr. Carreras. “Many patients at advanced ages do quite well with this procedure.”
If you have a family history of aortic stenosis, ask your doctor about a special heart screening.
One last doctor’s note: While aortic stenosis is most common in older adults, it can occur earlier in life too.
“Some patients develop aortic stenosis due to a genetic condition,” says Dr. Carreras. “If you have any family members with aortic stenosis, especially those with onset at a young age, I encourage consulting your doctor and discussing the possibility of screening for aortic stenosis.”