Aortic Valve Disease
A heart condition affecting the valve between the left ventricle and the aorta
What is Aortic Valve Disease?
Aortic valve disease occurs when the aortic valve, which controls blood flow from the heart's left ventricle to the aorta (the body's main artery), doesn't work properly. This can involve the valve not opening fully (aortic stenosis), not closing properly (aortic regurgitation), or both. The condition can develop gradually over many years or occur suddenly due to infection or other causes.
Common Symptoms
Aortic valve disease can cause various cardiovascular symptoms:
- Shortness of breath - Difficulty breathing, especially during activity
- Sharp chest pain - Chest discomfort or angina-like pain
- Palpitations - Irregular or rapid heartbeat sensations
- Irregular heartbeat - Abnormal heart rhythm or arrhythmias
- Groin mass - May indicate complications or associated conditions
- Fainting - Loss of consciousness due to reduced blood flow
- Peripheral edema - Swelling in legs, ankles, and feet
- Difficulty breathing - Breathlessness, especially when lying flat
- Lymphedema - Fluid retention causing swelling
Common Causes
Aortic valve disease can result from various factors:
Congenital Causes
- Bicuspid aortic valve: Born with two leaflets instead of three
- Unicuspid aortic valve: Rare condition with only one leaflet
- Quadricuspid aortic valve: Four leaflets instead of normal three
Acquired Causes
- Age-related calcification: Calcium deposits on valve leaflets
- Rheumatic heart disease: Complication of untreated strep throat
- Endocarditis: Infection of the heart valves
- Aortic root dilation: Enlargement of the aorta affecting valve function
- Connective tissue disorders: Marfan syndrome, Ehlers-Danlos syndrome
- Radiation therapy: Previous chest radiation treatment
Types of Aortic Valve Disease
Aortic Stenosis
The valve leaflets become stiff and narrow, restricting blood flow from the heart. This forces the heart to work harder to pump blood.
Aortic Regurgitation
The valve doesn't close properly, allowing blood to leak back into the left ventricle. This can lead to volume overload of the heart.
Mixed Aortic Valve Disease
A combination of stenosis and regurgitation, where the valve both doesn't open fully and doesn't close properly.
Disease Severity
Mild
Minimal symptoms, normal exercise tolerance. Regular monitoring recommended.
Moderate
Some symptoms during exertion. Closer monitoring and possible activity restrictions.
Severe
Significant symptoms affecting daily life. Usually requires surgical intervention.
Treatment Options
Medical Management
- Blood pressure medications: ACE inhibitors, beta-blockers for regurgitation
- Diuretics: To reduce fluid buildup and swelling
- Anticoagulants: Blood thinners for patients with artificial valves
- Activity restrictions: Avoiding strenuous exercise in severe cases
- Regular monitoring: Echocardiograms to track progression
Surgical Treatments
- Aortic valve replacement (AVR): Replacing the valve with mechanical or biological valve
- Transcatheter aortic valve replacement (TAVR): Less invasive valve replacement
- Aortic valve repair: Repairing the existing valve when possible
- Ross procedure: Using patient's own pulmonary valve to replace aortic valve
Valve Types
- Mechanical valves: Durable but require lifelong blood thinners
- Biological valves: From animal tissue, may need replacement in 10-20 years
When to Seek Medical Care
Seek immediate medical attention if you experience:
- Severe chest pain or pressure
- Fainting or near-fainting episodes
- Severe shortness of breath, especially at rest
- Rapid or irregular heartbeat
- Sudden onset of severe symptoms
Schedule routine medical evaluation for:
- Gradual decrease in exercise tolerance
- Mild chest discomfort during activity
- Swelling in legs or feet
- Fatigue that's getting worse
Potential Complications
- Heart failure: Heart muscle weakening from overwork
- Arrhythmias: Irregular heart rhythms, including atrial fibrillation
- Sudden cardiac death: Rare but serious complication of severe stenosis
- Stroke: From blood clots or emboli
- Endocarditis: Infection of the abnormal valve
- Heart block: Electrical conduction problems
Lifestyle Modifications
- Follow a heart-healthy diet low in sodium
- Maintain a healthy weight to reduce heart workload
- Exercise as recommended by your cardiologist
- Avoid tobacco and limit alcohol consumption
- Take prescribed medications consistently
- Practice good dental hygiene to prevent endocarditis
- Get regular medical check-ups and follow-up care
Prevention
- Treat strep throat promptly to prevent rheumatic fever
- Maintain good dental hygiene to prevent endocarditis
- Control risk factors like high blood pressure and diabetes
- Avoid illicit drugs, especially IV drugs
- Inform healthcare providers about valve disease before procedures
- Take prophylactic antibiotics when recommended