Testing & diagnosis for aortic valve stenosis in children

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Contact the Congenital Heart Valve Program

How is aortic valve stenosis diagnosed?

The process of arriving at a diagnosis of aortic valve stenosis usually involves several steps.

Often, a clinician will first notice that your child has a heart murmur is simply a telltale noise blood makes as it flows from the left ventricle to the aorta.

Heart murmurs can be detected with a stethoscope during a routine physical examination or with an electrocardiogram (EKG or ECG), a test that records the heart’s electrical activity and shows any abnormal rhythms or unusual stress. Sometimes, the murmur may emerge when the child is being tested or treated for another condition altogether.

The loudness of the murmur, where in the chest it is best heard and the types of noise it causes (such as gurgling or blowing) will all give your child’s clinician a better idea of the nature of your child’s heart problem. 

(Did you know heart defects can even be detected when a baby is still in the womb? Learn more about how Boston Children’s monitors fetal heartbeats.)

Although exams and electrocardiograms can suggest the possibility of aortic valve stenosis, an echocardiogram is the definitive test used to confirm the diagnosis. An echocardiogram is a special procedure that uses ultrasonic sound waves to create images of the heart and its structures. Echocardiograms are painless, do not require an IV and only take about an hour to perform.

Other tests your child’s clinician might order to make, or rule out, a diagnosis of aortic valve stenosis can include:

Questions to ask your doctor about aortic valve stenosis

You and your family play an essential role in your child’s treatment for aortic valve stenosis. It’s important that you share your observations and ideas with your child’s treating physician, and that you have all the information you need to fully understand the treatment team’s explanations and recommendations. 

You’ve probably thought of many questions to ask about your child’s aortic valve stenosis. It’s often very helpful to jot down your thoughts and questions ahead of time and bring them with you, along with a notebook, to your child’s appointment. That way, you will have all of your questions in front of you when you meet with your child’s treating clinician and can make notes to take home with you. (If your child is old enough, you can encourage him or her to write down questions, too.)
Initial questions to ask your doctor might include: 

  • How did you arrive at this diagnosis?
  • Are there any other conditions my child might have instead?
  • Does my child require further testing or procedures?
  • How advanced is the aortic valve stenosis?
  • What is my child’s prognosis?
  • What medications will you prescribe and what are possible side effects?
  • Is interventional catheterization necessary at this time?
  • Will my child need valve surgery? If so, what will the surgery entail?
  • How should I talk to my child about this condition?
  • How should I explain my child’s condition to others?
  • Do I need to restrict my child’s physical activity?
  • Does my child need to take antibiotics to protect against a bacterial infection?
  • Do I need to make any other changes to my child’s home and school routines?
  • What other resources can you point me to for more information?
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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