Aortic Valve Disease

Aortic valve disease refers to any condition that affects how the aortic valve works. This valve controls blood flow from the heart into the aorta and the rest of the body. When it doesn't open or close properly, it can lead to significant strain on the heart and serious health complications. The two main types are aortic stenosis (narrowing) and aortic regurgitation (leakage).

There are two major types of aortic valve disease:

• Aortic Stenosis – The valve doesn’t open fully, limiting blood flow.
• Aortic Regurgitation – The valve doesn’t close properly, causing blood to leak backward into the heart.
• Rheumatic Heart Disease – Scarring from rheumatic fever can cause the valve to thicken and restrict movement.
• Congenital Valve Abnormalities – Most commonly a bicuspid aortic valve (two leaflets instead of three), which may lead to either stenosis or regurgitation over time.

Some patients may experience both conditions, known as mixed aortic valve disease.

Aortic valve disease may be congenital, age-related, or develop as a result of infections or inflammatory conditions. Risk factors vary depending on the cause.

• Aging and Calcium Buildup – Most common cause of stenosis.
• Congenital Heart Defects
• Rheumatic Fever – Can damage the valve.
• Endocarditis – infection of the heart.
• Connective tissue disorders – like Marfan syndrome.
• High Blood Pressure – Can contribute to valve damage.
• High Cholesterol
• Smoking
• Family history of heart valve disease

In early stages, aortic valve disease may cause no symptoms. As the condition worsens, it can lead to signs of reduced blood flow or heart failure:

• Shortness of breath during activity
• Chest pain or tightness, especially during activity
• Fatigue, especially with exertion
• Dizziness or fainting spells
• Irregular heartbeat or palpitation
• Swelling in the legs or feet

If left untreated, symptoms can worsen and lead to heart failure.

Accurate diagnosis is key to determining the best treatment. Common tests include:

• Echocardiogram – Visualizes valve movement and measures blood flow.
• Electrocardiogram (EKG) – Detects electrical heart activity.
• Chest X-ray – May show signs of an enlarged heart.
• Cardiac MRI or CT – Offers detailed imaging of valve and heart function, especially for procedural planning.
• Cardiac Catheterization – Occasionally used to measure heart pressure and blood flow.

Treatment depends on disease type and severity:

• Monitoring – Regular follow-up and imaging for mild or asymptomatic cases.
• Medications – May help manage symptoms like high blood pressure or heart failure but do not correct valve function.
• Surgical Aortic Valve Replacement (SAVR) – Open-heart surgery to replace the valve.
• Transcatheter Aortic Valve Replacement (TAVR) – A minimally invasive alternative, ideal for many high-risk or elderly patients.
• Balloon Valvuloplasty – Temporary relief, often used in younger patients or emergencies.

Without proper treatment, complications can include:

• Heart Failure – Due to the heart overworking.
• Arrhythmias – Abnormal heart rhythms.
• Stroke – Caused by blood clots or irregular blood flow.
• Endocarditis – Risk of infection on a damaged valve.
• Sudden Cardiac Death

While some causes of aortic valve disease, such as congenital conditions, cannot be prevented, you can reduce your risk or slow progression by:

• Treating infections like strep throat early
• Managing blood pressure and cholesterol
• Avoiding smoking
• Stay physically active
• Regular heart checkups for high-risk individuals