Aortic valve disease refers to conditions in which the aortic valve, located between the left ventricle and the aorta, does not open or close properly. Because this valve controls blood flow from the heart to the entire body, aortic valve disease can place significant strain on the heart and affect overall circulation.
The condition may progress slowly over years or present with sudden symptoms. Early recognition and timely treatment are essential to prevent irreversible heart damage.
How the Aortic Valve Normally Works
The aortic valve opens with each heartbeat to allow oxygen-rich blood to flow from the left ventricle into the aorta and then closes tightly to prevent blood from leaking back into the heart. Proper valve function ensures efficient forward blood flow and maintains normal blood pressure.
When the valve becomes narrowed or leaky, the heart must work harder to maintain adequate circulation.
Types of Aortic Valve Disease
Aortic valve disease generally occurs in two main forms. Some patients may have a combination of both.
Aortic Stenosis
Aortic stenosis occurs when the valve becomes narrowed and does not open fully. This restricts blood flow from the heart to the body and increases pressure within the left ventricle. Over time, this can lead to thickening of the heart muscle and reduced heart function.
Aortic stenosis is most commonly caused by age-related calcification of the valve, but it may also result from congenital valve abnormalities or rheumatic heart disease.
Aortic Regurgitation
Aortic regurgitation occurs when the valve does not close completely, allowing blood to leak backward into the left ventricle after each heartbeat. This backward flow causes the ventricle to enlarge and work harder to maintain forward output.
Aortic regurgitation may be caused by valve degeneration, infection, congenital abnormalities, or dilation of the aorta.
Symptoms of Aortic Valve Disease
Symptoms often develop gradually and may not appear until disease is advanced.
Common symptoms include shortness of breath, chest pain or pressure (especially with exertion), fatigue, dizziness or fainting, and reduced exercise tolerance. In advanced cases, heart failure symptoms such as leg swelling or breathlessness at rest may occur.
Some individuals remain asymptomatic despite significant valve disease, underscoring the importance of regular follow-up.
How Aortic Valve Disease Is Diagnosed
Echocardiography is the primary diagnostic tool and allows assessment of valve structure, severity of narrowing or leakage, heart chamber size, and heart function.
Additional testing may include electrocardiography, chest imaging, exercise testing, or advanced imaging such as CT or cardiac MRI. These tests help determine disease severity, guide treatment decisions, and plan interventions.
Treatment Options for Aortic Valve Disease
Treatment depends on the type of valve disease, symptom burden, severity, and overall heart function. The goals are to relieve symptoms, improve survival, and prevent irreversible heart damage.
Medical Therapy
Medications do not correct the structural valve problem but may help control symptoms and manage complications.
Drug therapy may be used to manage high blood pressure, relieve fluid congestion, or treat associated arrhythmias. In aortic regurgitation, medications that reduce afterload can help reduce stress on the heart in selected patients.
Medical therapy is often used while monitoring disease progression or in patients who are not immediate candidates for valve intervention.
Aortic Valve Replacement
For severe symptomatic aortic valve disease, valve replacement is the definitive treatment. Once symptoms develop, particularly in severe aortic stenosis, timely valve replacement significantly improves survival and quality of life.
Surgical Aortic Valve Replacement (SAVR)
Traditional open-heart surgery involves removing the diseased valve and replacing it with a mechanical or biological (tissue) valve. Surgical replacement provides excellent long-term results, especially in younger or lower-risk patients.
Transcatheter Aortic Valve Replacement (TAVR)
Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure in which a new valve is delivered through a blood vessel, most commonly from the leg, without open-heart surgery. TAVR has become an established treatment for many patients with severe aortic stenosis, particularly those at intermediate or high surgical risk.
Timing of Intervention
One of the most important aspects of aortic valve disease management is choosing the right time for intervention. Waiting too long can lead to permanent heart damage, even if symptoms are mild.
Regular follow-up with echocardiography allows early detection of disease progression and timely referral for valve replacement.
Management of Complications
Aortic valve disease may lead to heart failure, arrhythmias, or enlargement of the heart chambers. Treating these associated conditions is an essential part of comprehensive care.
Anticoagulation may be required after valve replacement, depending on the type of valve used.
Living With Aortic Valve Disease
Many people with mild or moderate aortic valve disease live active lives with regular monitoring. For those who undergo valve replacement, modern surgical and transcatheter techniques allow significant improvement in symptoms and long-term outcomes.
Patient education, shared decision-making, and follow-up in experienced valve centers are key components of successful management.
In Summary
Aortic valve disease affects the valve that controls blood flow from the heart to the body and most commonly presents as aortic stenosis or aortic regurgitation. While early disease may require only monitoring, severe cases benefit from timely valve replacement using surgical or transcatheter techniques. With appropriate treatment, many patients achieve excellent symptom relief and improved survival.
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Reference: Aortic Valve Disease
