A B C D E F G H I J K L M N O P R S T U V W

VALVE DISEASE : AORTIC

Why does Aortic Valve Disease occur ?

An aortic valve may be abnormal at birth: although this valve normally has three cusps it sometimes has two. This does not cause problems until later in life when it may become narrowed and cause aortic stenosis. Another defect at birth can cause aortic regurgitation later. These defects may be found at birth but aortic stenosis or regurgitation may also be caused later by rheumatic fever. There are also several other causes of aortic regurgitation. It may occur with joint diseases such as rheumatoid arthritis, ankylosing spondylitis, and a rarer condition called Reiter's syndrome. It may also occur with the skin condition psoriasis and as a long-term complication of syphilis. This is now rare. Infection on an abnormal aortic valve leads to a disease called infective endocarditis . This usually produces or causes a worsening of any leaking of the valve.

Treatment Involved in Aortic Valve Disease

DIAGNOSIS This is usually made at a medical examination, but tests such as chest x-rays and electrocardiograms (ECGs) are helpful. A test, called echocardiography, uses high frequency sound (ultrasound) to confirm the diagnosis and to judge how severe it is. The ultrasound comes from a microphone-like instrument, called a transducer, placed on the chest. The sound is reflected off the heart, back to the transducer, where it is converted into electrical impulses which are displayed as a TV picture. A similar method (Doppler) measures the blood flowing through the valve. It is a good way of measuring the narrowing or leaking of an abnormal aortic valve. If there is doubt about the severity, a cardiac catheterization may be needed. This involves threading small tubes, called catheters, into the heart from blood vessels in the arm or groin. It is usually needed before an operation.

TREATMENT A mild valve abnormality needs no treatment. The symptoms of heart failure (breathlessness and ankle swelling) need medication called diuretics. These get rid of the excess fluid that the kidneys retain and you pass more urine. If this treatment is not enough or if the valve defect (particularly stenosis) poses any threat, valve replacement surgery must be considered.

During Treatment

Regular check-ups are important to make sure that the valve defect and its effect on the heart's pumping does not become dangerous. If you get breathless, you should seek advice. Treatment may need to be started or increased. If you have aortic stenosis (narrowing), a blackout or dizziness may mean some deterioration has occurred. You should then see your doctor as soon as possible. If germs get into the bloodstream there is a risk of getting infection on an abnormal aortic valve. This is called infective endocarditis. Germs get into the blood through the gums after dental treatment or with other operations or investigations which use instruments passed inside the body. Prevention, by taking antibiotics, is better than cure. They are given, usually by mouth, an hour before dentistry or an operation. You should carry a card with all the details. Show it to any doctor or dentist treating you.

If Aortic Valve Disease is left Untreated

Aortic stenosis may eventually cause blackouts or even sudden death. Regular check-up is essential to ensure that it does not get worse. If the condition is severe it is extremely important to have a new valve inserted. For aortic regurgitation, regular checks are also important to make sure that the heart is not strained. This may happen even with mild symptoms. If valve surgery is left too late, it may then be too late to make any difference to your symptoms or outlook.

Effects on family of Aortic Valve Disease

You should be able to lead a relatively normal life although you may have to take less exercise. This should not affect your family or friends unduly. An abnormal aortic valve means regular medical checks. Remember to have antibiotics before dentistry or other surgery.