Someone living with aortic stenosis that progresses quickly often has a worse outlook. But you can take steps to catch this heart issue early and work with your healthcare team to treat it.

Your aortic valve is one of four valves in your heart. It’s like the exit valve of your heart, where oxygen-rich blood is pumped out of the heart to the rest of your body. As the main portal for blood to flow to all your tissues, it’s important that your aortic valve remains clear and open.

Over time — or with certain structural problems that can be present at birth — the aortic valve can become narrowed with calcium deposits, inflammation, and stiffening that limits blood flow. This condition — aortic stenosis — is one of the most common reasons for heart valve surgery.

This article explores how quickly aortic stenosis can develop and progress, what you might feel as this is happening, and what can be done to correct this problem.

How quickly aortic stenosis develops and progresses can vary from person to person based on age, the underlying reason for the stenosis, and other health problems that may exist.

Calcification or hardening of the aortic valve over time is the leading cause of aortic stenosis.

There’s no confirmed formula to determine why some aortic stenosis diagnoses progress quickly, while others happen more slowly. But research indicates that rapid progression usually leads to more severe disease and higher rates of complications or death.

Aortic stenosis is staged based on how much blood flow to the aorta is limited and what other cardiac problems have developed from decreased blood flow.

The American College of Cardiology uses letters to describe Stages A–D, while the European Heart Journal uses numbers to classify Stages 0–4, and the descriptions are slightly different.

  • Stage 0: At this stage, aortic stenosis is present but has not caused any other damage to heart tissue or function.
  • Stage 1: Aortic stenosis has affected the heart’s pumping ability in the left ventricle or left bottom chamber of the heart. This ventricle is where oxygen-rich blood is pumped to the rest of the body.
  • Stage 2: Damage in this stage extends to the left atrium of the heart and causes one of the other valves (mitral valve) to not close properly and to leak. This is known as mitral regurgitation. Another feature of this stage is an irregular heart rhythm (atrial fibrillation).
  • Stage 3: In this stage of aortic stenosis, additional valves and blood vessels in the heart are negatively affected. This can include the pulmonary artery and tricuspid valve, which help control the flow of blood between your heart and lungs. Problems in these vessels can lead to pulmonary hypertension.
  • Stage 4: With this level of aortic stenosis, the bottom right chamber or ventricle becomes weak and damaged.

Staging of aortic stenosis is usually done with an echocardiogram. Generally, people who have higher stages of aortic stenosis are older, male, and have other contributing health problems.

There are several health problems that can exist alongside aortic stenosis and contribute to its development and how fast it progresses.

Older people and those in already frail health often progress through this disease more quickly and with more extensive cardiac damage.

People who have aortic stenosis that’s progressed to severe aortic stenosis may also have:

Symptoms that can appear with aortic stenosis are related to how limited blood flow becomes. For many people, symptoms don’t appear until blood flow is significantly restricted through the aortic valve and other heart or cardiac damage develops.

When symptoms do appear, they can include things like:

  • chest pain
  • heart palpitations or fluttering
  • shortness of breath
  • dizziness or fainting
  • low tolerance for routine daily activities
  • swollen feet or ankles
  • difficulty sleeping or lying flat
  • increased fatigue

As aortic stenosis progresses to later stages, symptoms become more severe and may evolve into other serious conditions like heart failure or pulmonary hypertension.

Learn more about the symptoms of heart failure and symptoms of pulmonary hypertension.

People with severe symptoms and advanced stages of aortic stenosis have the highest risk of sudden death. Sudden death can also occur in people without symptoms of aortic stenosis, but this is less common.

Although rates of progression to higher stages varies, people whose condition progresses more quickly to more serious stages of aortic stenosis over a shorter period of time usually have worse outcomes and higher rates of dying.

Stages 4 and 5 have the highest rates of death and other complications. But according to experts, research suggests that even stage 1 of aortic stenosis has a 9.2% mortality rate 1 year after diagnosis.

Early diagnosis and treatment with valve replacement surgery can help prevent stenosis leading to additional cardiac damage. Currently, there are limited other treatment measures that can help prevent, slow, or stop aortic stenosis progression.

Aortic stenosis can develop without symptoms, but over time, the stiffening and narrowing of the aortic valve decreases blood flow from the heart out to the rest of the body. This can lead to severe symptoms that reduce your daily ability to function, which can cause complications like heart failure. Aortic stenosis progression can even lead to death.

Early recognition, confirmed diagnosis, and treatment with valve replacement and medications can help improve blood flow through your aortic valve and prevent further damage to the heart.