Aortic Valve Disease
What are the symptoms of aortic
valve disease?
Early on, you may have no symptoms.
As aortic valve disease gets worse, you may experience:
Chest pain or discomfort.
Fainting (syncope).
Heart palpitations.
Shortness of breath (dyspnea) with
exertion, when lying down or when sleeping.
Swelling (edema) in your feet and
ankles.
What causes aortic valve disease?
Causes of aortic valve disease
include:
Wear and tear due to aging.
Rheumatic heart disease.
Congenital heart disease.
High blood pressure.
Endocarditis.
Trauma to your chest.
Thoracic aortic aneurysm.
Aortic dissection.
Radiation to your chest (such as
treatment for cancer).
What are the risk factors?
You face a higher risk for aortic
valve disease if you:
Are over age 60.
Have aortic valve sclerosis
(thickening and calcification of your valve that doesn’t yet narrow the
opening).
Have a congenital heart valve
defect, especially a bicuspid aortic valve.
Have a history of rheumatic fever.
Have a history of endocarditis.
Have certain underlying conditions,
including Marfan syndrome, Ehlers-Danlos syndrome and lupus.
What are the stages of aortic valve
disease?
Aortic valve disease gradually gets
worse over time. Healthcare providers use these stages to describe the severity
of your condition:
Stage A (at risk). Your aortic valve
is working fine, but you have at least one risk factor for aortic valve
disease.
Stage B (progressive). This is mild
or moderate aortic valve disease. There are some changes to your valve
function, but you don’t have symptoms.
Stage C (asymptomatic severe). This
is severe aortic valve disease. You don’t have symptoms during your normal
routine. However, you may feel some symptoms during an exercise stress test. In
stage C1, your heart can still pump out enough blood to meet your body’s needs.
In stage C2, your heart can’t pump out enough blood (your left ventricular
ejection fraction is below 50%).
Stage D (symptomatic severe). You have
severe aortic valve disease that causes symptoms during your daily life. Early
on, you may only have symptoms during physical activity. But later, you may
have symptoms at rest.
What are the complications of aortic
valve disease?
Aortic valve disease is serious and
can lead to complications when untreated. The most common complication is heart
failure. This is when your heart can’t pump enough blood to meet your body’s
needs. Other complications include:
Arrhythmia.
Heart attack.
Sudden cardiac arrest.
Stroke.
How is aortic valve disease
diagnosed?
Healthcare providers diagnose aortic
valve disease through a physical exam and testing.
During an exam, a provider:
Asks about your medical history.
Checks your vital signs.
Uses a stethoscope to listen to your
heart (auscultation). A murmur may indicate aortic valve disease.
Performs an electrocardiogram (ECG).
You may also need one or more
additional tests. An echocardiogram is the gold standard for diagnosing aortic
valve disease. This test uses high-frequency sound waves (ultrasound) to take
pictures of your heart.
Other tests you may need include:
Cardiac catheterization.
Cardiac computed tomography (CT)
scan.
Chest X-ray.
Coronary angiogram.
Exercise stress test.
Heart MRI.
What is the treatment for aortic
valve disease?
Treatment depends on:
The specific type of aortic valve
disease you have (stenosis, regurgitation or both).
How far it’s progressed (the stage).
The severity of your symptoms.
Your healthcare provider will
evaluate your situation and recommend the best treatment plan for you.
Treatment options include:
· Medications. Medications can’t fix your valve,
but they manage your symptoms and reduce your risk of complications. Your
provider may prescribe medications to prevent arrhythmias, lower your blood
pressure, manage your cholesterol or treat heart failure.
· Valvuloplasty. This minimally invasive procedure
uses a small balloon to open up your aortic valve. This improves blood flow through
your valve if you have aortic stenosis. It’s a temporary solution until you
have valve surgery.
· Heart valve surgery. Surgery repairs or replaces
your aortic valve with either a tissue valve or a mechanical heart valve.
Surgeons sometimes combine valve surgery with coronary artery bypass grafting
(CABG) or other heart surgeries.
· Transcatheter aortic valve replacement (TAVR).
TAVR is a minimally invasive alternative to traditional heart valve surgery. It
avoids having to undergo open heart surgery, instead delivering you a new
aortic valve without removing your old valve. Your new valve fits inside your
old valve.
· Ross procedure. This surgery helps people under
age 60 who need a new aortic valve. A surgeon replaces your aortic valve with
your pulmonary valve, and then gives you a donor pulmonary valve. This
procedure can help avoid having to place a mechanical heart valve in the aortic
position, but it’s a more complicated procedure.