Aortic Stenosis: Symptoms, Tests, and How Treatment Decisions Are Made

A clear guide for patients and families facing questions about a narrowed aortic valve.

Important: This is general education. It cannot diagnose a valve problem or choose treatment for an individual. New, severe, or sudden chest pain, fainting, severe breathlessness, or a collapse needs urgent medical help.

What is aortic stenosis?

The aortic valve is the exit door from the heart to the body. In aortic stenosis, that door becomes narrowed. The heart must work harder to push blood through it.

The condition can be mild, moderate, or severe. Some people feel well for years. Others develop symptoms gradually. The degree of narrowing, the effect on the heart, and the person’s overall health all matter.

Symptoms worth discussing

Symptoms are not a diagnosis. They can have many causes. Still, they should not be dismissed as “just getting older,” especially when they limit normal activity.

Breathlessness during activity or when lying flat
Chest pressure, pain, or discomfort
Dizziness, near-fainting, or fainting
New tiredness or a reduced ability to walk, climb stairs, or exercise
Palpitations or swelling around the ankles or abdomen

Seek urgent assessment for severe or sudden symptoms. Do not drive yourself if you feel faint or have serious chest pain.

How doctors assess the valve

A good assessment starts with the whole person, not only a scan. The clinical team will ask about symptoms, daily activity, medical history, medicines, and goals. They may listen for a heart murmur and check blood pressure, pulse, and signs of fluid retention.

An echocardiogram, often called an echo, is the main test used to assess a heart valve. It uses sound waves to show the valve, blood flow, heart size, and pumping function. Depending on the situation, the team may also use an ECG, blood tests, CT imaging, cardiac catheterisation, or a monitored exercise test.

A useful result is not simply “you have a murmur.” Ask what the echo shows, how severe the narrowing is, whether the heart has been affected, and when the next review is due.

When is treatment considered?

Not every narrowed valve needs an immediate procedure. Some people need regular follow-up while the valve is mild or moderate and they remain well. Treatment is considered when the narrowing is severe, symptoms appear, the heart is affected, or testing shows a concerning change.

Medicines may help control related problems such as high blood pressure, fluid retention, or an irregular rhythm. They do not replace a severely narrowed valve. When replacement is needed, the main options may include surgical aortic valve replacement or a catheter-based procedure called TAVI or TAVR.

Why one treatment is not right for everyone

Choosing treatment is a shared decision. A specialist heart team weighs the valve anatomy, age, general health, other heart conditions, previous surgery, access through blood vessels, expected valve durability, recovery needs, and the person’s preferences.

“Less invasive” does not automatically mean “best.” A catheter procedure may be a strong option for some people. Surgery may be a strong option for others. The right choice follows a complete assessment.

Questions to take to your appointment

How severe is my aortic stenosis?
Are my symptoms likely to be related to the valve?
What does my echocardiogram show about my heart function?
Do I need monitoring, more tests, or treatment now?
What are the benefits and risks of each option in my situation?
What should make me seek urgent help before my next review?

Key message

Aortic stenosis is manageable when it is assessed carefully and followed appropriately. The most useful next step is a clear conversation built around your symptoms, test results, and priorities.

Frequently asked questions

Can aortic stenosis cause no symptoms?

Yes. Some people have no symptoms, which is one reason planned follow-up and repeat echocardiograms can matter.

Can exercise make aortic stenosis worse?

Activity advice is individual. Ask the treating team what level of activity is safe for you. Do not start or intensify an exercise plan based on a general article.

Does every person with aortic stenosis need valve replacement?

No. The need and timing depend on severity, symptoms, heart function, and the full clinical assessment.

Sources

Educational information only. Reviewed for source accuracy on 9 September 2026. It is not a substitute for advice from your own clinical team.