How Is Aortic Stenosis Different From Other Valve Diseases?

Aortic stenosis — when the aortic valve in your heart becomes narrow or blocked, making it difficult for blood to pass through — is considered a heart valve disease.

But how does aortic stenosis compare to other heart valve diseases, like aortic regurgitation or mitral stenosis? Cardiologist L. Leonardo Rodriguez, MD, explains the differences.

What’s the difference between aortic stenosis vs. other heart valve diseases?

Aortic stenosis is just one type of heart valve disease. Heart valve disease affects how one or more of the four different valves in your heart work. A problem with one of your heart valves may make your heart work harder because there’s too much pressure or volume of blood within your heart.

Let’s learn more about how aortic stenosis compares to other heart valve diseases.

Aortic stenosis vs. aortic regurgitation

Aortic stenosis happens when it becomes difficult for blood to pass through the aortic valve before it leaves your heart to travel to other parts of your body. But with aortic regurgitation (also known as aortic insufficiency), the leaflets (flaps) of the aortic valve don’t close properly. The leaky leaflets cause some of the blood that was set to leave your heart to travel back down your aortic valve.

Think of it as a blocked hallway versus a door that doesn’t close tightly. Either way, there’s more strain on your heart to pump blood.

“The main difference between aortic stenosis and aortic regurgitation is the type of workload it causes on the heart,” clarifies Dr. Rodriguez. “When the valve is narrow, the heart has to pump harder. With aortic regurgitation, there’s a volume overload, which makes your heart larger.”

Symptom differences

In both, you may experience the following symptoms:

• Fatigue
• Chest pain
• Heart palpitations
• Fainting
• Shortness of breath
• Swelling in your feet (edema)

Risk factor differences

While the risk of both valve diseases increases as you age or if you have a history of rheumatic fever, other risk factors of aortic regurgitation include:

• Congenital valve disorders like a bicuspid aortic valve (when you’re born with two leaflets vs. three)
• Aortopathy (conditions that weaken your aorta)
• Prior to aortic valve replacement (which can deteriorate over time)

Aortic stenosis vs. mitral valve stenosis

Your heart has four valves. The left side of your heart contains both your aortic valve and your mitral valve.

These valves are located in different parts of your heart. The aortic valve sits between your left ventricle and your aorta, while your mitral valve is located between your left ventricle and your left atrium.

And they each serve a different purpose. Think of your mitral valve as a conductor. It makes sure blood flows in the right direction to your left ventricle. From there, blood travels to your aortic valve, which is responsible for pushing blood to the rest of your body,

If you have stenosis — either in your aortic valve or your mitral valve — it means the same thing: Your valve has become narrowed or blocked. This typically occurs due to a buildup of calcium in those areas.

“In the case of aortic stenosis, it’s an obstacle for pumping blood out of your heart,” explains Dr. Rodriguez. “While with mitral valve stenosis, it’s an obstacle for filling blood into your left ventricle.”

Another difference? Aortic stenosis is common, especially in people over the age of 65, but mitral valve stenosis isn’t that common. In the U.S., it affects about 1 out of 100,000 people.

Symptom differences

Like aortic stenosis, you may experience fatigue, shortness of breath, heart palpitations and swelling in your ankles and feet with mitral valve stenosis. Additional symptoms include:

• Coughing up blood
• Hoarseness
• Bronchitis
• Stroke

Risk factor differences

You’re more likely to have mitral valve stenosis if you’re female or have a blood relative with the heart condition.

A quick note about aortic stenosis vs. aortic sclerosis

You may think aortic stenosis and aortic sclerosis are the same, but they’re slightly different. Aortic sclerosis is when your aortic valve leaflets become thicker or calcified. But this doesn’t restrict blood flow. In some cases, aortic sclerosis can progress into aortic stenosis.

“Sclerosis is the very early stage of aortic valve thickening and calcification and provides the environment for the development of aortic stenosis,” says Dr. Rodriguez.

Key takeaways

While many of the symptoms and risk factors for aortic stenosis and other heart valve diseases are the same, it’s important to work with a healthcare provider to determine which specific heart valve disease you have.

The type of heart valve disease you have can affect your treatment plan and determine what kind of medication you need. It can also help your healthcare provider determine if surgery is necessary.

“Heart valve diseases are a chronic condition,” says Dr. Rodriguez. “You’ll need to work with your care team to treat and manage your specific heart valve disease, potentially through medication, lifestyle changes, like following a heart-healthy diet, and/or a valve replacement or repair.”