Description

Aortic valve disease is a type of heart valve disease. In this condition, the valve that is located between the lower left chamber of the heart and the main artery of the body is not functioning properly.

The aortic valve helps to keep the blood flowing in the correct direction through the heart. A damaged or diseased aortic valve can affect the flow of blood to the rest of the heart and of the body.

Aortic valve disease includes:

  • Stenosis of the aortic valve. Each of the heart valves have flaps of tissue that open and close once during each heartbeat. The caps are also called edges. Sometimes the aortic valve flaps become thick and stiff, or are connected together. These problems cause the valve opening is narrow. The narrowing of the valve reduces or blocks blood flow from the heart to the rest of the body.
  • Aortic valve regurgitation. The aortic valve does not close properly, causing blood to flow backward into the left lower chamber of the heart.

A person may be born with the disease of the aortic valve. This is called a congenital defect of the heart. Sometimes the disease of the aortic valve occurs later in life due to other health conditions.

The treatment for aortic valve disease depends on the type and severity of the disease. Some people may need surgery to repair or replace the aortic valve.

Symptoms

Some people with aortic valve disease may not notice symptoms for many years. The symptoms of aortic valve disease may include:

  • Chest pain or tightness.
  • The dizziness.
  • Fainting.
  • Fatigue after activity or be less able to be active.
  • Irregular beating of the heart.
  • Shortness of breath, especially during vigorous activity or when lying down.
  • Not eating enough. This is mainly seen in children with aortic valve stenosis.
  • Not gaining enough weight. This is mainly seen in children with aortic valve stenosis.

When to see a doctor

If you are experiencing sudden chest pain, call 911 or your local emergency number.

Make an appointment for a health checkup if you have symptoms of aortic valve disease, such as shortness of breath, fatigue after activity, or sensation of a pounding or irregular heartbeat. Sometimes the first symptoms of the disease of the aortic valve are associated with heart failure. Get a health checkup if you have fatigue that does not improve with rest, shortness of breath and swelling of the ankles and feet, which are the most common symptoms of heart failure.

Causes

Aortic valve disease can be caused by a problem in the heart that are present at birth is called a congenital defect of the heart. Other causes of aortic valve disease later in life, which include:

  • Age-related changes to the heart.
  • Infections.
  • The high blood pressure.
  • Injury in the heart.

To better understand the causes of disease of the aortic valve, it can be helpful to know how the heart valves tend to work.

The heart has four valves that keep blood flowing in the right direction. These valves are:

  • The aortic valve.
  • Of the Mitral valve.
  • Tricuspid valve.
  • The pulmonary valve.

Each valve has flaps, also called cusps or leaflets, that open and close once during each heartbeat.

In the disease of the aortic valve, the valve that is located between the lower left chamber of the heart and the main artery of the body is not functioning properly. The lower left chamber of the heart called the left ventricle. The main artery of the body is called the aorta.

The valve may be thick and rigid, or it may be that the valve does not close properly.

Risk factors

There are many things that can increase the risk of aortic valve disease, including:

  • Advanced age. The calcium can build up on the aortic valve as the age of the people, causing the aortic valve to harden and narrow.
  • Heart valve problems present at birth, called congenital heart defects. Some people are born with a missing, extra, or fusion of the valve. This increases the risk of regurgitation of the aortic valve.
  • Rheumatic fever. This complication of strep throat can cause aortic stenosis, a type of heart valve disease. If you have diseases of the heart valves due to rheumatic fever, it is called rheumatic heart disease. If not, is called nonrheumatic heart disease.
  • The inflammation of the lining of the heart chambers and valves, called endocarditis. This life-threatening condition is usually caused by an infection. You can damage the aortic valve.
  • History of radiation therapy to the chest. Some types of cancer are treated with radiation therapy. The symptoms of heart valve disease may not be noticed until many years after the radiation therapy is received.
  • Other health conditions. Chronic kidney disease, lupus, and Marfan syndrome, a connective tissue disease, may increase the risk of aortic stenosis or regurgitation.

Complications

Possible complications of aortic valve disease may include:

  • The blood clots.
  • Stroke.
  • Heart failure.
  • Problems with heart rhythms, called arrhythmias.
  • Death due to a sudden cardiac arrest.

Proper diagnosis and treatment can help reduce the risk of complications.

Diagnosis

To diagnose the disease of the aortic valve, a healthcare professional will examine you and ask questions about your symptoms and medical history.

A whooshing sound called a heart murmur, you may hear when listening to the heart with a stethoscope. If so, you need to see a doctor trained in diseases of the heart, called a cardiologist.

Tests

The tests to diagnose the disease of the aortic valve include:

  • The echocardiogram.An echocardiogram uses sound waves to create images of the beating heart. Shows how blood flows through the heart and the heart valves. You can help to determine the severity of the disease of the aortic valve. There are different types of echocardiograms. The type you have depends on the information of your health care team you need. An echocardiogram standard is performed from the outside of the body. The ultrasound device is gently pressed against the skin of the chest over the heart. If you need more over the heart, a transesophageal echocardiogram may be done. This type create images of the heart from the inside of the body. The ultrasound device is connected to a tube that goes down your throat and esophagus.
  • Electrocardiogram (ECG or EKG). This quick test records the electrical activity of the heart. Shows how the heart beats. Adhesive patches placed on the chest and sometimes the legs. The cables connect the patches to a computer, which displays or prints the results.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. This can help determine if the heart is enlarged, which may be a sign of certain types of disease of the aortic valve, or heart failure.
  • CardiacMRI. A cardiac mri uses magnetic fields and radio waves to create detailed pictures of the heart. This test can be used to determine the severity of the disease of the aortic valve and measure the size of the aorta.
  • Cardiac computed tomography (CT scan). A cardiac ct scan uses a series of X-rays to create detailed pictures of the heart and heart valves. The test may be done to measure the size of the aorta and look at the aortic valve more closely. The CT scan also can be used to measure the amount of calcium in the aortic valve, or to determine the severity of the stenosis of the aortic valve.
  • Exercise tests or stress tests. These tests often involve walking on a treadmill or riding a stationary bike while an ECG or echocardiogram. Exercise tests show how the heart reacts to physical activity, and if the valve symptoms of the disease occur during the exercise. If you can't do the exercise, you can receive a drug that affects the heart as the exercise you do.
  • The cardiac catheterization. This test is not often used to diagnose the disease of the aortic valve. But that can be done to see how severe aortic valve disease is or to diagnose the condition if other tests do not. In this test, a thin, flexible tube that is inserted into a blood vessel, usually in the area of the groin or arm and guided to the heart. Cardiac catheterization can provide more details about the flow of the blood and how well your heart is working. Certain heart treatments can be done during cardiac catheterization.

The echocardiogram. An echocardiogram uses sound waves to create images of the beating heart. Shows how blood flows through the heart and the heart valves. You can help to determine the severity of the disease of the aortic valve.

There are different types of echocardiograms. The type you have depends on the information of your health care team you need. An echocardiogram standard is performed from the outside of the body. The ultrasound device is gently pressed against the skin of the chest over the heart. If you need more over the heart, a transesophageal echocardiogram may be done. This type create images of the heart from the inside of the body. The ultrasound device is connected to a tube that goes down your throat and esophagus.

Assay

After the test confirms a diagnosis of the aorta or other heart valve disease, your health care team can tell you that the stage of the disease. Staging helps to determine the most appropriate treatment.

The stage of heart valve disease depends on many things, including symptoms, severity of the disease, the structure of the valve or valves and the flow of blood through the heart and lungs.

Heart valve disease is staged in four basic groups:

  • Stage A: At risk. Risk factors for heart valve disease are present.
  • Stage B: Progressive. Valve disease is mild or moderate. No valve of the heart of the symptoms.
  • C-stage: Asymptomatic severe. There is no heart valve symptoms, but the disease of the valve is severe.
  • Stage D: Symptomatic severe. Heart valve disease is severe and is causing the symptoms.

Treatment

The treatment for aortic valve disease depends on:

  • The severity (stage) of the disease of the aortic valve.
  • If the disease is causing the symptoms.
  • If the disease is getting worse.

The treatment may include regular medical checkups, lifestyle changes, medications, or surgery, or other procedures. If you have aortic valve disease, consider the possibility of being evaluated and treated at a medical center with a multidisciplinary team of heart doctors called cardiologists and other healthcare professionals trained and experienced in the assessment and treatment of heart valve disease.

Drugs

If the aortic valve disease is mild or moderate, or if you have no symptoms, you may only need regular medical tests to see the condition.

Heart-healthy lifestyle changes and medicines may be needed to treat the symptoms of the disease of the aortic valve or reduce the risk of complications. For example, medications can be used to:

  • Lower blood pressure.
  • Avoid irregular heart beats.
  • Remove excess fluid from the body to reduce the strain on the heart.

Surgery or other procedures

Finally, a surgery or a catheter procedure may be needed to repair or replace the diseased aortic valve. Some people with aortic valve disease need surgery, even if it is not severe, or when it does not cause symptoms.

Surgery to repair or replace the aortic valve is often done with an open-heart surgery. Sometimes, the valve can be replaced during the minimally invasive heart surgery, which uses smaller incisions than those required for open-heart surgery, or with a catheter-based procedure.

Repair of the aortic valve

During repair of the aortic valve, the surgeon may do one or all of the following:

  • Apart from the valve flaps that have been merged.
  • Add support for the base of the valve.
  • Reform or eliminate the excess valve tissue so that the tops can be closed tightly.
  • Patch holes or tears in valve.

Repair of the aortic valve often requires open-heart surgery. However, less-invasive options available. For example, a catheter procedure can be used to insert a plug or a device for the repair of a leaking aortic valve replacement.

In infants and children with aortic valve stenosis, a less invasive procedure called balloon valvuloplasty can do to temporarily open a narrowing of the valve. During this procedure, the doctor inserts a thin, hollow tube into a blood vessel, usually in the groin, and threads for the heart. A balloon is inflated to widen the opening of the valve. Then the balloon is deflated and removed. This valve repair procedure can also be performed on adults who are too sick for surgery, or who are waiting for a replacement of the valve.

Replacement of the aortic valve

In aortic valve replacement, the surgeon removes the damaged valve and replaces it with a mechanical valve or a valve from a cow, pig or human heart tissue. A tissue valve that is called a biological tissue valve.

Sometimes, the aortic valve is replaced with his own lung of the valve called the pulmonary valve. Then, his pulmonary valve is replaced with a biological lung tissue of the valve. This more complicated the surgery is called the Ross procedure.

You and your health care team will explain the benefits and risks of each type of valve to make the best choice for you.

Replacement of the aortic valve usually requires open-heart surgery. Sometimes, surgeons can use a minimally invasive procedure called transcatheter aortic valve replacement (TAVR) to replace a narrowing of the aortic valve with a biological tissue valve. TAVR uses smaller incisions than those used in open-heart surgery. TAVR may be an option for people at increased risk of complications from heart valve surgery.

Lifestyle and home remedies

After the diagnosis or treatment of the disease of the aortic valve, you'll need regular health checkups. Your health care team can suggest to make a heart-healthy lifestyle changes. Try these steps:

  • Eating a heart-healthy diet. Eat a variety of fruits and vegetables, low-fat or non-fat dairy products, poultry, fish and whole grains. Avoid saturated and trans fats and excess salt and sugar.
  • Maintain a healthy weight. Ask your health care team what is a healthy weight for you.
  • Get regular exercise. As a general goal, aim for at least 30 minutes of moderate physical activity every day. Check with your health care team before starting a new exercise routine.
  • Manage stress. Find ways to help reduce emotional stress. Do more exercise, the practice of mindfulness and connecting with others in support groups are some of the ways to tame your stress.
  • Do not smoke. If you need help to stop smoking or using tobacco, ask a health professional about resources for help. Join a support group can be helpful.

Pregnancy

If you have aortic valve disease, it is important to talk with a health care professional before you get pregnant. Careful and regular check-ups are needed if you have aortic valve disease during pregnancy. Your health care team can discuss with you which medicines are safe to use during pregnancy. Your health care team may also determine if the valve disease treatment is necessary prior to the pregnancy.

Health professionals may recommend that people with a severe disease of the heart valve to prevent the pregnancy to avoid the risk of complications.

Coping and support

If you have aortic valve disease, here are some steps that can help you manage the condition:

  • Take the medicines as prescribed. Take your medicines as directed by your health care team.
  • Get support. Connect with others who have the same or similar condition may be useful. Ask your health care team about support groups in your area.
  • Stay active. Regular exercise is one of the best ways to improve heart health. Ask a health care professional about how much and what types of physical activity are safe for you.

Preparing for your appointment

If you think you have the disease of the aortic valve, make an appointment for a health checkup. Here's some information to help you prepare for your appointment.

  • Be aware of pre-appointment restrictions. When you make the appointment, ask if there is something that you need to do beforehand.
  • Write down your symptoms, including any that seem unrelated to the disease of the heart valve.
  • Write important personal information, including a family history of heart disease, and any major stresses or recent life changes.
  • Make a list of all the medicines, vitamins, and supplements you are taking. Include the dose.
  • Have a family member or friend along, if possible. Someone who goes with you can help you remember the information that you receive.
  • Write questions to ask their health care team.

For aortic valve disease, some basic questions to ask your health care team include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes for my symptoms or condition?
  • What tests are needed?
  • What is the best treatment?
  • What are the options for the primary treatment you are suggesting?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • If I need surgery, a surgeon who would I recommend to the heart valve surgery?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

Don't hesitate to ask other questions you have.

What to expect from your doctor

Your health care team is likely to ask many questions, including:

  • When did your symptoms begin?
  • Do you always have symptoms or the symptoms come and go?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Aortic valve disease