Is Severe Aortic Stenosis Hereditary? Causes and Risk Factors | MyHeartDiseaseTeam

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Is Severe Aortic Stenosis Hereditary? Causes and Risk Factors

Medically reviewed by Colleen O’Brien-Podulka, CRNP
Written by Maureen McNulty
Posted on December 8, 2023

  • In aortic stenosis, blood doesn’t flow properly through the aortic valve, which opens and closes to keep blood flowing in the right direction through the heart.

  • The condition is not genetic (passed from parent to child), but aging, infections, and certain health conditions can increase a person’s risk for developing severe aortic valve stenosis.

A diagnosis of severe aortic stenosis may come as a surprise. You may wonder where this disease came from and what it means for your family — why did it develop? Are your siblings or children at risk for also having the condition?

In general, aortic stenosis — also called aortic valve stenosis — is not a genetic disease. This means it is not usually passed down from parent to child. Rather, it’s typically caused by factors that occur throughout your lifetime, including getting older and developing certain infections or other diseases. However, some genetic disorders can increase your risk of developing aortic stenosis.

Read on to learn more about the factors — genetic and otherwise — that can lead to severe aortic stenosis.

Causes of Aortic Stenosis

Aortic stenosis develops due to problems with a person’s heart valves and the valve leaflets that open and close to keep blood properly moving in the right direction.

Your heart has four chambers (spaces) that work together to send oxygen-containing blood around your body. The left ventricle is the final chamber that blood passes through before it moves into your aorta (the large artery that carries the blood to the rest of your tissues). In between your left ventricle and aorta lies a valve called the aortic valve. When your heart beats, the aortic valve briefly opens to allow the blood to flow out of your heart.

If you have aortic stenosis, your aortic valve opening is too narrow, commonly due to calcium buildup or scarring damage. Blood can’t easily flow through the opening. As a result, your heart has to work harder to pump blood, eventually making it weaker.

Aortic stenosis occurs when the aortic valve becomes blocked or narrowed. This causes your heart to work harder to pump blood. (Adobe Stock)

What Causes Aortic Stenosis To Become Severe?

Left untreated, aortic stenosis can get worse over time, progressing from mild to moderate to severe disease. Your heart muscle may gradually get thicker, interfering with its ability to properly fill and pump enough blood to all of the tissues throughout your body. Eventually, untreated mild aortic stenosis may progress to a more serious condition, like severe aortic stenosis or heart failure (when the heart can’t pump enough blood to meet the body’s needs).

Your aortic valve stenosis is more likely to get worse quickly if you:

  • Are older
  • Have obesity
  • Have been diagnosed with hypertension (high blood pressure), high cholesterol levels, high blood glucose (sugar levels), or a high calcium heart score
  • Smoke cigarettes or use other tobacco products

Severe Aortic Stenosis Risk Factors

Several factors can increase your chances of developing severe aortic stenosis. While you can’t control several of these factors, you may be able to change others to modify your risk. Talk to your doctor about your risk factors, as well as your family medical history of heart disease.

Aging

Aortic stenosis is more common in older adults. The older you are, the more calcium builds up in your heart valves. This condition, called atherosclerosis, can make your valves stiffer and lead to problems with blood flow.

Aortic stenosis most often affects people over the age of 60. The disease is usually mild at first, and often doesn’t become severe and start causing symptoms until you’re in your 70s or 80s.

Congenital Heart Condition

Some people are born with valves that work a little differently than usual, referred to as a congenital heart condition or birth defect. These issues may increase your risk of severe aortic stenosis. People who develop an aortic stenosis condition at a younger age often have valve problems that were present since birth.

Whereas most people have three cusps (flaps) in their aortic valve, some are born with only two. Called bicuspid aortic valve, this condition may lead to problems with blood flow. Your valves may also be stiffer than usual, causing aortic stenosis. Bicuspid aortic valve is one of the most common congenital heart conditions.

Some people are born with only two cusps (flaps) in their aortic valve, instead of three. This is known as bicuspid aortic valve. This congenital heart defect increases the risk of aortic stenosis. (Adobe Stock)

Infection

In some cases, aortic stenosis occurs following infective endocarditis, an infection of the heart valves that can occur when bacteria get into the bloodstream. This may be caused by many factors, including:

  • Dental procedures
  • Small cuts, scrapes, or wounds on your gums or the inside of your mouth
  • Certain skin conditions
  • Burns
  • IV catheters or IV drug use
  • Infection of prosthetic implants (valves, joints, devices)

Doctors use antibiotics to treat endocarditis. This therapy can help prevent heart damage and reduce your risk of heart valve diseases like aortic stenosis.

Rheumatic Fever

Rheumatic fever is a condition that typically affects children. It may develop if an infection like strep throat goes untreated. Symptoms include a rash, tender joints, muscle aches, tiredness, chest pain, and headaches. It also leads to swelling — and eventually scarring — in many of your body’s tissues, including your heart valves.

In the U.S., rheumatic fever is rare because strep throat is typically treated with antibiotics before it causes serious problems. However, if you had rheumatic fever when you were younger, you may develop severe aortic stenosis later in life if the condition damaged your aortic valve.

Other Conditions

You may also develop severe aortic stenosis as a result of other medical conditions, including:

  • Lupus — An autoimmune disease in which your immune system attacks your healthy tissues
  • Fabry disease — A condition in which your body can’t properly break down proteins and fat
  • Alkaptonuria — A rare genetic disease that causes difficulty breaking down proteins and makes your urine appear black
  • Ochronosis — Another rare disease makes breaking down proteins difficult for your body and can cause certain areas of your skin appear gray, blue, or black

Can Severe Aortic Stenosis Be Prevented?

Although there’s no guaranteed way to prevent aortic stenosis, taking good care of your teeth and treating infections are steps you can take to reduce your risk. Lifestyle changes that promote heart health can support your overall well-being and may reduce your chances of developing other health problems. Regular checkups with your doctor can help detect problems early before they progress.

Practice Good Oral Hygiene

Infections of the teeth and gums can cause bacteria to leak into your bloodstream. In fact, one study found that the risk of bacteria in your blood is eight times higher if you experience bleeding after you brush your teeth. If this bacteria travels to your heart, it can lead to endocarditis.

To reduce your risk of infection and keep your teeth and gums healthy, floss and brush your teeth twice per day and visit the dentist once per year or more. Tell your dentist if you have gum disease symptoms such as swollen or bleeding gums, ongoing bad breath, pain in a tooth when you chew, or gums that are pulling away from your teeth. In these cases, you should also discuss any upcoming health procedures with your dentist to determine if taking preoperative antibiotics may help minimize your risk of heart infection.

Get Treated for Strep Throat

Because strep throat can turn into rheumatic fever and damage the heart, it’s important to get proper treatment if you develop this infection.

Talk to your doctor if you or your child experience strep throat symptoms such as a very red throat, pain while swallowing, small red spots on the roof of your mouth, or swollen or white-streaked tonsils (round tissues in the back of the throat). Antibiotic treatments can help prevent rheumatic fever and protect heart health.

Embrace a Heart-Healthy Lifestyle

Adopting heart-healthy habits is not a guarantee against developing aortic stenosis. However, making lifestyle changes that are good for your heart may minimize your risk for other health complications.

To boost your heart health, try:

  • Eating more plant-based foods, including fruits, vegetables, and whole grains
  • Consuming fewer foods that harm your heart, including items high in fat and salt
  • Adding more physical activity to your routine by doing more aerobic exercise (activity that increases your heart rate), resistance training (lifting weights), and stretching exercises
  • Quitting smoking and stopping using other tobacco products
  • Drinking alcohol in moderation, which means having no more than two drinks per day for men and one drink per day for women, per guidelines from the Centers for Disease Control and Prevention (CDC)
  • Treating high blood pressure and high cholesterol with the help of your doctor
  • Finding healthy, stress-busting activities such as meditating, spending time with friends, or trying talk therapy

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people living with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 59,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Have you been diagnosed with aortic stenosis? Do you have a family history of the condition or other types of cardiovascular disease? Do symptoms of aortic stenosis affect your daily life? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on December 8, 2023
All updates must be accompanied by text or a picture.

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Colleen O’Brien-Podulka, CRNP . Learn more about her here
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here

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