Why it hides so well
The narrowing develops over years, and the body quietly adjusts: the walk gets a little shorter, the hills get avoided, the pauses on the stairs become normal. In a UK study that scanned 2,500 adults over 65, half were found to have some previously undetected valve disease — mostly mild — and clinically significant disease was newly discovered in about one in fifteen [2]. The valve narrows slowly; the habits shrink around it [1][2].
The four signals worth respecting
Against a background of ordinary ageing, these deserve attention — especially when they are new, or newly worse [1][3]:
- Breathlessness out of proportion — hills or stairs that were manageable last year and are not this year.
- Chest tightness or heaviness that comes with exertion.
- Tiredness that has changed gear rather than simply grown.
- Light-headedness — or actual blackouts — on effort, which should never be filed under ageing [1][3].
The half-hour answer
An echocardiogram — an ultrasound scan of the heart — measures the valve directly: how narrowed it is, and how the heart is coping behind it. It is painless, radiation-free, and settles the question in a single visit [1][5]. If the valve is fine, you have bought certainty. If it is narrowed, you have bought time — which is the one thing this condition rewards.
What happens if a valve is found
A narrowed valve that causes no symptoms is usually watched, with scheduled echoes, not rushed to treatment [3][4]. The turning point is symptoms: once severe narrowing starts causing them, guidelines favour replacing the valve — by open surgery or by TAVI, a decision a Heart Team makes with you [3][4]. That decision is covered in detail in our TAVI article; the first step is far simpler — finding out where you stand.
For sons and daughters, too
This is the article to act on for a parent as much as for yourself. If someone you love has quietly stopped doing things they used to do, an echocardiogram is a small, kind, decisive way to find out why.
