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    3. Aortic stenosis
    cardiology, valvular heart disease and cardiovascular medicine

    Aortic stenosis

    Also known as: aortic stenosis, aortic valve stenosis, calcific aortic stenosis, severe aortic stenosis, bicuspid aortic valve stenosis, valvular heart disease, left ventricular outflow obstruction

    Aortic stenosis is narrowing of the aortic valve opening, restricting blood flow from the left ventricle into the aorta. In adults it is commonly caused by progressive calcification and stiffening of the valve, while younger patients may have a congenital bicuspid aortic valve. Rheumatic valve disease is another possible cause. Mild or moderate disease may remain asymptomatic for years, but increasing obstruction can place substantial pressure stress on the left ventricle and eventually cause heart failure, arrhythmia, reduced coronary blood flow, syncope or sudden death. Typical symptoms of significant disease include exertional breathlessness, chest pain or pressure, reduced exercise capacity, dizziness, fainting and fatigue. Patients with severe symptomatic aortic stenosis commonly require aortic valve replacement through surgical aortic valve replacement or transcatheter aortic valve implantation. Acupuncture and Chinese herbal medicine cannot reverse valve calcification, enlarge the valve opening or replace valve intervention. Possible post-assessment patterns include Heart Qi deficiency, Heart Yang deficiency, Qi and Yin deficiency, Phlegm-Dampness obstructing the chest, Qi stagnation with Blood stasis and Heart-Spleen deficiency with anxiety. [1][2][3][4]

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    Lifestyle & Diet

    • •Attend all scheduled cardiology appointments and echocardiograms.
    • •Report any new exertional breathlessness, chest discomfort, dizziness, fainting or reduced exercise capacity promptly.
    • •Take prescribed cardiovascular medicines exactly as directed.
    • •Do not stop blood-pressure, diuretic, anticoagulant, antiplatelet, rhythm or cholesterol medicines without consulting the prescriber.
    • •Follow individual exercise advice from the cardiology team.
    • •Avoid strenuous exertion when symptomatic severe aortic stenosis has not been treated.
    • •Do not exercise through chest pain, dizziness or unusual breathlessness.
    • •Participate in cardiac rehabilitation following valve replacement when offered.
    • •Stop smoking and avoid second-hand smoke.
    • •Maintain a balanced heart-supportive diet.
    • •Manage blood pressure, cholesterol, diabetes and coronary risk factors.
    • •Monitor body weight and swelling only according to the medical care plan.
    • •Seek review for rapid weight gain, increasing ankle swelling or worsening breathlessness.
    • •Maintain dental hygiene and obtain regular dental care because bloodstream infection may threaten heart valves.
    • •Tell dentists and clinicians about prosthetic valves or previous infective endocarditis.
    • •Use antibiotic prophylaxis only when prescribed according to current cardiac and dental guidance.
    • •Avoid unregulated supplements advertised as dissolving valve calcium.
    • •Discuss all herbal medicines with the cardiologist or pharmacist before use.
    • •Carry an updated medicine list and relevant valve information.
    • •Seek psychological support when fear of exertion, intervention or sudden death becomes disabling.
    • •Call triple zero (000), rather than driving, for severe chest pain, collapse or major breathing difficulty.
    • •After TAVI or surgery, follow wound, lifting, driving and activity instructions precisely.

    Cautions & Contraindications

    See sources
    • •Do not treat symptomatic severe aortic stenosis solely with acupuncture, herbs, supplements or lifestyle measures.
    • •Do not delay echocardiography, cardiology review, TAVI or surgical valve replacement.
    • •Do not encourage strenuous exercise in symptomatic severe disease without cardiology clearance.
    • •Do not treat exertional syncope, chest pain or breathlessness as ordinary Qi deficiency.
    • •Do not use acupuncture during acute heart failure, unstable chest pain or haemodynamic instability.
    • •Do not perform strong chest cupping, vigorous massage or forceful manipulation.
    • •Do not needle over recent cardiac surgical wounds, pacemaker sites or vascular access sites.
    • •Do not advise stopping warfarin, antiplatelets or other cardiovascular medicines.
    • •Do not claim Chinese medicine can decalcify or reopen the aortic valve.
    • •Fù Zǐ requires correct processing and should be avoided in unstable cardiovascular disease because of cardiotoxicity and arrhythmia risk.
    • •Má Huáng should generally be avoided because it may increase heart rate and blood pressure.
    • •Dān Shēn, Dāng Guī, Chuān Xiōng, Táo Rén, Hóng Huā and Niú Xī may increase bleeding risk.
    • •Gān Cǎo may worsen hypertension, oedema, heart failure and hypokalaemia.
    • •Rén Shēn may interact with warfarin, diabetic medicines and cardiovascular treatment.
    • •Avoid unregulated mineral products because of heavy-metal and contamination risks.
    • •Screen all herbs for kidney or liver disease, pregnancy, arrhythmia, anticoagulation and perioperative timing.
    • •Do not interpret increasing breathlessness, swelling, chest discomfort or faintness as a detoxification or healing response.

    When to reassess or seek care again

    See sources
    Review timelines
    • •Review symptoms, functional capacity and medication tolerance at every visit.
    • •Confirm cardiology follow-up and echocardiography surveillance schedule is being met.
    • •Reassess adjunctive TCM care after every cardiology or valve intervention update.
    Recurrence triggers — return for reassessment
    • •New exertional syncope, chest pain or breathlessness.
    • •Rapid weight gain, increasing oedema or orthopnoea.
    • •Fever, new murmur or signs suggesting infective endocarditis.
    • •Post-procedural bleeding, wound issues or neurological symptoms.

    Stop TCM care and escalate immediately if any red flag emerges; do not resume until cardiology clears the patient.

    Frequently Asked Questions

    What is aortic stenosis?+

    Aortic stenosis is narrowing of the aortic valve opening, which restricts blood flow from the left ventricle into the aorta [3].

    What causes aortic stenosis?+

    Common causes include age-related valve calcification, congenital bicuspid aortic valve and rheumatic heart disease [3].

    What symptoms suggest severe disease?+

    Exertional breathlessness, chest pain, reduced exercise capacity, dizziness and fainting are important warning symptoms [3].

    How is aortic stenosis diagnosed?+

    Echocardiography is central to diagnosis and measurement of valve severity, ventricular function and blood-flow obstruction [3].

    Can medicines open a narrowed aortic valve?+

    Medicines may manage associated conditions but do not reopen a severely calcified valve [3].

    How is severe symptomatic aortic stenosis treated?+

    Treatment commonly requires surgical aortic valve replacement or transcatheter aortic valve implantation [3].

    Can acupuncture treat aortic stenosis?+

    Acupuncture cannot reverse valve narrowing. It may be considered only for limited adjunctive symptom support in medically stable patients [5].

    Are Chinese herbs safe before valve replacement?+

    Some herbs affect bleeding, blood pressure, rhythm or anaesthesia and should be reviewed by the cardiology and pharmacy team [5].

    Is fainting during exercise dangerous?+

    Yes. Exertional fainting in a person with known or suspected aortic stenosis requires urgent medical assessment [3].

    Can severe aortic stenosis be asymptomatic?+

    Yes. Some patients report no symptoms despite severe measurements, so specialist surveillance and sometimes supervised exercise testing are important [3].

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    Sources & Further Reading

    Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.

    1. Heart Foundation Australia — What is heart valve disease?
      Heart Foundation Australia · 2026
    2. Heart Foundation Australia — Improving outcomes for patients with aortic stenosis
      Heart Foundation Australia · 2024
    3. 2025 ESC/EACTS Guidelines for the management of valvular heart disease
      European Society of Cardiology / EACTS · 2025
    4. Asymptomatic patients with aortic valve stenosis: diagnosis and risk stratification
      European Society of Cardiology · 2026
    5. WHO Standard Acupuncture Point Locations in the Western Pacific Region
      World Health Organization · 2008
    6. WHO Benchmarks for the Practice of Acupuncture
      World Health Organization · 2020

    Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.

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