Aortic Valve Disease


Heart valve disorders include aortic valve disease. The valve between the body's main artery (the aorta) and the lower left cardiac chamber (left ventricle) malfunctions in aortic valve disease.

The aortic valve aids in maintaining proper blood flow through the heart. Blood flow to the body and the rest of the heart might be impacted by an unhealthy or damaged aortic valve.

Included in aortic valve disease are −

  • Stenosis of the aortic valve −The aortic valve's flaps (cusps) enlarge and stiffen, or they merge. The narrowing of the valve aperture is a result of these issues. Blood flow from the heart to the body's other organs is decreased or blocked by the constricted valve.

  • Valve regurgitation in the aorta − Blood flows backward into the left lower heart chamber as a result of the aortic valve failing to seal correctly (ventricle).

Aortic valve disease can develop later in life as a result of other medical disorders or it might be present at birth (congenital heart disease).

The type and degree of the illness determine the course of treatment for aortic valve disease. Surgery may be required in some cases to replace or repair the aortic valve.

Aortic Valve Disease: Causes

A cardiac abnormality that was present at birth may be the cause of aortic valve disease (congenital heart defect). Later in life, aortic valve disease can also be brought on by −

  • Cardiac alterations brought on by aging

  • Infections

  • Elevated blood pressure

  • The heart is injured

Knowing how the heart valves normally function may be useful in understanding the causes of aortic valve illness.

Four valves in the heart keep blood moving in the right way. They are as follows −

  • Aortic valve

  • Mitral valve

  • Tricuspid valve

  • Pulmonary valve

Every pulse causes the flaps (also known as cusps or leaflets) on each valve to open and close once. A valve may occasionally fail to open or close correctly. Due to this, blood flow from the heart to the rest of the body may be impeded or reduced.

The valve between the body's main artery (the aorta) and the lower left cardiac chamber (left ventricle) malfunctions in aortic valve disease. The valve may be stenosed, which makes it thick and rigid, or it may not shut completely, which allows blood to flow backward.

Aortic Valve Disease: Symptoms

Aortic valve disease patients might go years without experiencing any symptoms. Aortic valve disease symptoms and signs might include −

  • Sound of a whooshing or swishing heart (heart murmur)

  • Stiffness or discomfort in the chest

  • Dizziness

  • Fainting

  • Fatigue following activity or a decrease in one's capacity for activity

  • Abnormal heartbeat

  • Breathlessness, especially while engaging in strenuous exercise or when lying down

  • Failing to eat enough (mainly in children with aortic valve stenosis)

  • Not putting on enough pounds (mainly in children with aortic valve stenosis)

Get immediate medical assistance if you have abrupt chest discomfort. If you experience any of the warning signs or symptoms of valve disease, including shortness of breath, exhaustion after exercise, or feelings of a pounding or irregular heartbeat, schedule an appointment with a healthcare professional.

Heart failure may be a factor in the onset of the initial symptoms of aortic valve dysfunction. If you have exhaustion that doesn't improve with rest, shortness of breath, or swelling ankles or feet, which are classic signs of heart failure, consult a medical professional.

Aortic Valve Disease: Risk Factors

The major risk factors include −

  • Age − As people age, calcium deposits can accumulate on the aortic valve, causing the valve to stiffen and narrow.

  • Issues with the cardiac valves exist from birth (congenital heart defects). Aortic valve regurgitation is more likely in those who are born with a missing, excess, or fused valve flap (cusp), which increases mortality.

  • Arthritis fever, Aortic stenosis, a form of valve disease, can be brought on by this strep throat side effect. Rheumatic heart disease is the medical term for heart valve damage brought on by rheumatic fever. Otherwise, it is known as nonrheumatic heart disease.

  • Inflammation of the heart's chambers and valves' lining (endocarditis). Infection is typically to blame for this potentially fatal illness. The aortic valve may get harmed.

  • History of chest radiation treatment− Radiation treatment is used to treat certain cancers. Many years after radiation therapy has been administered, symptoms of heart valve damage may not become apparent.

  • Other health issues. Aortic stenosis or regurgitation risk factors include chronic renal illness, lupus, and the connective tissue disorder Marfan syndrome.

Aortic Valve Disease: Diagnosis

To diagnose aortic valve disease, your doctor may suggest the following diagnosis procedures −

  • Echocardiogram − Echocardiography is a heart ultrasound. Sound waves may be utilized to visualize the beating heart in action. Echocardiography gives a clearer view of the aortic valve and the aorta's health. It can assist in identifying the origin and extent of aortic valve disease.

  • Electrocardiogram (ECG or EKG) − This non-invasive examination captures the heart's electrical activity. On the chest and occasionally the legs are inserted sticky patches containing sensors (electrodes). The patches are connected by wires to a computer, which shows the results.

  • A chest X-ray  An X-ray of the chest can reveal the health of the heart and lungs.

  • Heart MRI  A cardiac MRI produces precise pictures of the heart using magnetic fields and radio waves.

  • Computed tomography (CT) scan of the heart. An X-ray sequence is used in a cardiac CT scan to provide finely detailed pictures of the heart and heart valves.

  • Stress testing or exercise tests  These examinations frequently include a treadmill or stationary bike walking or cycling while an ECG or echocardiogram is being performed.

  • Catheterization of the heart The diagnosis of aortic valve disease does not frequently employ this test. However, if other tests are unable to detect the illness, they may be used to assess the degree of aortic valve dysfunction.

Aortic Valve Disease: Treatment

A patient with aortic valve diseases can be prescribed the following treatments −

Medications

If your aortic valve disease is mild or moderate, or if you don't have any symptoms, regular checks with your doctor may be all that's required to keep track of the problem.

To treat the signs and symptoms of aortic valve disease or lower the risk of consequences, doctors may advise taking medicines and adopting heart-healthy lifestyle modifications. For instance, drugs might be used to −

  • Blood pressure reduction

  • Avoid erratic heartbeats

  • To ease the strain on the heart, eliminate extra fluid from the body.

Surgical Repair

The damaged aortic valve may eventually require surgical repair or replacement using a catheter. Even when the condition is not severe or when there are no symptoms, some persons with aortic valve disease require surgery.

Aortic valve surgery is frequently performed during open-heart surgery. Sometimes the valve can be replaced with a catheter-based operation or during minimally invasive heart surgery, which requires fewer incisions than open heart surgery.

Replacement of the Aortic Valve

In an aortic valve replacement, the diseased valve is removed and replaced by a mechanical valve, a valve composed of cow, pig, human heart tissue, or both (biological tissue valve).

Aortic Valve Disease: Prevention

Consume heart-healthy foods. Aortic valve narrowing may occur significantly more quickly in those with high cholesterol than in those with normal cholesterol levels.

  • Monitor your blood pressure

  • Give up smoking

  • Maintain good oral and gum health

  • Check for a cardiac murmur

Conclusion

It is crucial to take valve disease into account, especially in elderly individuals who have exertional symptoms. The ideal approach is to refer people with moderate or severe valve disease to a specialized valve clinic for additional assessment and guidance for surveillance or intervention as necessary. Echocardiography is the undisputed initial investigation.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha

MBBS MS [ OPHTHALMOLOGY ]

Updated on: 03-Mar-2023

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