Aortic Stenosis: How Fast Does It Progress?

If you’ve been diagnosed with aortic stenosis (or aortic valve stenosis), you may wonder how fast aortic stenosis progresses.

This heart condition, defined by a narrowing or blockage of your aortic valve, is common in people over 65 and can progress at different rates.

How fast does aortic stenosis progress?

“Aortic stenosis progress varies,” says cardiologist L. Leonardo Rodriguez, MD. “In some people, the progression is relatively slow. In others, it’s relatively faster and can cause serious complications like heart damage.”

Your aortic valve pushes blood to the rest of your body. When you have aortic stenosis, this valve can narrow or become obstructed — typically by a calcium buildup. This makes it more difficult for blood to pass.

Studies show that, on average, aortic stenosis gets narrower between 0.1 square centimeters to 0.3 square centimeters every year.

Certain risk factors can contribute to how fast it develops, like:

• Being older than 65
• Having high blood pressure
• Having high cholesterol
• Having coronary artery disease (CAD)
• Having kidney disease
• Using tobacco products

“People with kidney disease, particularly advanced kidney failure, tend to have aortic stenosis that progresses a lot faster,” notes Dr. Rodriguez. “Kidney disease affects the metabolism of calcium, so there are often deposits of calcium elsewhere in the body. One of the places this happens often is your heart valves.”

What aortic valve stenosis stages mean

To determine your diagnosis and the stage of aortic stenosis, your healthcare provider may conduct one or more tests, like a cardiac CT scan or an echocardiogram. These tests can help figure out how much your aortic valve has thickened and how the leaflets (the flaps that open to let blood pass through) work.

Based on your test results, your aortic stenosis may be classified as:

• Mild: Valve opening is more than 1.5 square centimeters
• Moderate: Valve opening is between 1.1 and 1.5 square centimeters
• Severe: Valve opening is less than 1.0 square centimeters

How slowly or quickly aortic stenosis progresses is unique to each person and is based on their age, other medical conditions they may have and additional risk factors. For example, if you have mild aortic stenosis, it could progress quickly if you’re older than 65 or have CAD.

Dr. Rodriguez says healthcare providers also use certain classifications of aortic stenosis based on additional damage to other areas of your heart. They include:

• Stage 0: Only the aortic valve is affected.
• Stage 1: There’s also damage to your left ventricle.
• Stage 2: There’s also damage to your mitral valve.
• Stage 3: There’s also damage to your tricuspid valve.
• Stage 4: There’s also damage to your right ventricle.

Signs your aortic stenosis is progressing

There’s a chance you could have aortic stenosis and not even know it. Some people may not have any symptoms until their aortic stenosis progresses to the moderate or severe levels.

“Some people with moderate stenosis will have symptoms, but some of these symptoms aren’t very specific,” explains Dr. Rodriguez. “You may experience fatigue or get tired easily after exercise. That can make it difficult to sort out a diagnosis.”

That’s why it’s important to talk to a healthcare provider about symptoms like chest pain, fainting and shortness of breath. They can order tests to clarify what’s causing your symptoms.

How to slow down aortic stenosis progression

It’s important to track and manage aortic stenosis to limit how quickly it advances. Don’t let it go untreated, as severe levels can cause serious complications like heart damage and even death.

But you can be proactive about your heart health. Dr. Rodriguez says, based on the progression of your aortic stenosis, your doctor may recommend:

• Lifestyle changes: Your doctor will work with you to determine a heart-healthy diet that’s right for you, such as eating low-salt and low-fat foods if your levels are severe. It’s also important to get regular exercise.
• Medication: While no medication slows down the progression of aortic stenosis, you may need to take medicine to manage other related issues like high blood pressure or high cholesterol.
• Surgery: Depending on the severity of your aortic stenosis, there are surgical options that can repair or replace your aortic valve, like valvuloplasty, the Ross procedure and transcatheter aortic valve replacement (TAVR).

“If you need surgery, your doctor would like you to be at your healthiest at the time of surgery,” states Dr. Rodriguez. “Things like exercise, diet and medication can make a surgery less risky and the recovery will be faster.”

Bottom line? If you have aortic stenosis, improving your health is vital. And your doctors are here to help.

“We address aortic stenosis in a holistic way,” says Dr. Rodriguez. “You should do everything in your power to improve your general health and try to slow down the progression.”