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Aortic Stenosis In Children: Advice For Parents

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Aortic stenosis is a serious heart problem that affects children and adults across the United States. In its mildest form, the condition may not even present any symptoms in infants or small children, but many people start to develop problems later in life. If a doctor diagnoses aortic stenosis in your child, he or she will recommend treatment as soon as possible, or the disease may become life-threatening. Learn what causes aortic stenosis, how the disease may affect your child, and the treatment options you may need to consider to improve your son's or daughter's life.

Causes of aortic stenosis

When your heart squeezes, the lower left chamber (left ventricle) contracts and pushes blood into the artery (aorta) that then moves blood around the body. A valve between the left ventricle and the aorta stops any blood leaking back into the heart. In patients with aortic stenosis, the aortic valve doesn't open properly. As such, the muscles in the ventricle have to work harder and thicken, which can lead to chest pain. In serious cases, blood may not reach vital parts of your child's body, like the brain.

Some children have aortic stenosis from birth. In these cases, the child is often born with a small aortic valve, or other heart abnormalities. In older people, the condition can occur as a result of another condition like rheumatic heart disease. For people over the age of 70, a build-up of calcium deposits is the most common cause of aortic stenosis.

What to look for

You may not notice any symptoms in milder cases of aortic stenosis, and many people don't experience side effects until adulthood. In babies, severe aortic stenosis often leads to decreased blood flow, which you may notice if the baby is very lethargic and struggles to feed. In some cases, the infant may also have problems breathing.

The signs of aortic stenosis can develop throughout childhood. Your son or daughter may show constant signs of fatigue and may suffer breathing problems during and after exercise. Many people with aortic stenosis find it hard not to cough at night when lying down, and some children can faint. A heart murmur or arrhythmia (irregular heart rhythm) can also point to aortic stenosis.

Children often inherit aortic stenosis. As such, you should always tell your cardiologist about any family history of the condition.

How doctors diagnose the condition

In critical cases, a hospital may notice the symptoms of aortic stenosis in a newborn child, and will immediately refer the child to a cardiologist for treatment or click here to get in touch with a cardiologist. In older children, your primary doctor will normally need to send your son or daughter to a specialist for one or more diagnostic tests. These tests include:

  • Pulse oximetry, which monitors the oxygen content in his or her blood
  • X-ray
  • Echocardiogram, where ultrasound waves create an image of your child's heart
  • Electrocardiogram (ECG) to record the heart's electrical activity
  • Magnetic resonance imagery (MRI) scan
  • Cardiac catheterization, which measures how well your child's heart is beating

These methods are mostly non-invasive, but the process can still seem very daunting to a child. A cardiologist will discuss the best options with you before carrying out any diagnostics.

Treatment options

In mild cases, your son or daughter will not normally need treatment, and a doctor will simply want to regularly check your child's health.

In moderate or severe cases, a cardiologist will generally suggest one or more types of treatment. He or she may prescribe medicines to help deal with symptoms like heart murmurs or arrhythmia. Your doctor may also prescribe drugs to help treat high blood pressure. Children with aortic stenosis also often need to take antibiotics to prevent serious bacterial infection (bacterial endocarditis). You'll need to let other medical professionals know that your child has aortic stenosis before they can carry out any other procedures.

Children with the condition may undergo a procedure known as balloon valvuloplasty. Doctors move a thin tube (catheter) to the heart through a vein in the leg. The catheter has a balloon on the end, which the doctor will briefly inflate, deflate and then withdraw. This process helps the aortic valve open fully, and older children can generally resume normal activity after a couple of days.

A cardiologist may also recommend other surgical options. These include:

  • Valvuloplasty surgery to repair or replace the valve
  • Replacement artificial heart valves
  • The Ross Procedure ( where a surgeon replaces the aortic valve with another valve)

Advances in medicine mean that most children with aortic stenosis go on to lead healthy, normal lives. That aside, many children will need lifelong follow-up care, and will probably need to regularly visit a cardiologist.

Learning that your child has a heart problem is a daunting prospect for any parent, so it's important to understand what to expect. Aortic stenosis is a serious condition, but with the right care and treatment, you can make sure your child lives a normal, healthy life.