Aortic Valve Disease

The heart is constantly pumping blood throughout your body. Essential to this process are your heart valves. These ensure blood flows in the right direction throughout your body. One crucial heart valve is the aortic valve, positioned between your heart's main pumping chamber (the left ventricle) and the aorta, your body's largest artery.

What is aortic valve disease?

Aortic valve disease occurs when the aortic valve malfunctions, disrupting the smooth flow of oxygenated blood through your heart, to the aorta, and then the rest of your body. This malfunction causes your heart to work harder and less efficiently. The malfunction may be due to narrowing of the aortic valve opening, a leak in the aortic valve, or both.

Early diagnosis and treatment of aortic valve disease can significantly improve your quality of life and prevent serious health complications. At AHN, we specialize in treating aortic valve disease allowing you to maintain an active and healthy life.

Aortic valve disease care at AHN: Why choose us?

At the AHN Cardiovascular Institute, we offer advanced, patient-centered care. Our heart valve specialists are experts in how to diagnose and treat heart valve problems. We offer many minimally invasive treatment options that allow our patients to return to their lives sooner.

By seeking care at AHN, you’ll find a dedicated care team who listens and develops a personalized treatment plan just for you. And, we work closely with your other doctors so your care is coordinated, and your needs are carefully considered throughout your treatment. Learn more about our team and our Aortic Valve Disease Program.

Aortic valve disease symptoms and signs

Symptoms of aortic valve disease can vary greatly depending on the severity of the disease. Many people, especially in the early stages, have no symptoms at all. However, as the disease progresses, common symptoms can include:

• Chest pain (angina): This is often described as a pressure or squeezing sensation in the chest, sometimes radiating to the arm, jaw, or neck. It's usually brought on by exertion and relieved by rest.
• Shortness of breath (dyspnea): This can occur during exertion or even at rest, as the heart struggles to pump enough blood.
• Lightheadedness or dizziness: These symptoms happen with activity and can be caused by reduced blood flow to the brain.
• Fainting (syncope): A more severe symptom, fainting indicating significant blood flow issues.
• Rapid or irregular heartbeat (palpitations): The heart may try to compensate for the valve problem by beating faster.
• Fatigue: You may feel constantly tired and lacking energy.
• Swelling in the legs, ankles, or feet (edema): Edema is a sign of fluid buildup, often seen in more advanced cases.

It's crucial to remember that these symptoms can also be caused by other conditions. Regular preventive care and talking with your doctor when you notice new or worsening symptoms are crucial to finding a disease or condition before it gets worse. It’s important to take care and not assume something is caused by old age. Early detection is key for managing aortic valve disease.

If you experience any of these symptoms, schedule an appointment with your doctor for proper diagnosis and treatment.

Causes and risk factors

Aortic valve disease has a few different causes and risk factors, and many are due to inherited conditions and health issues. Knowing these causes and risk factors — and talking about them with your doctor — can help you stay alert to any changes in your health that might indicate the disease. Often, aortic valve disease is caused by:

• Wear and tear: Just like any other part of your body, the aortic valve can wear out over time. This is more common as people get older.
• Birth defects: Sometimes, people are born with a problem in their aortic valve. This could mean the valve is the wrong shape or size.
• Infections: Serious infections like rheumatic fever, strep throat, and even bacteria from poor oral health can damage the aortic valve.
• Connective tissue disorders: Some diseases, like Marfan syndrome and Ehlers Danlos Syndrome (EDS), affect the body's connective tissues (the things that hold things together). This can weaken the aortic valve.
• High blood pressure (hypertension): Constant high blood pressure puts extra strain on the aortic valve, which can weaken it over time.
• Trauma: Injury to the chest can damage the aorta and aortic valve.
• Aortic aneurysm: An aortic aneurysm is a ballooning, weakened area in the upper portion of the aorta.
• Aortic dissection: An aneurysm that becomes a tear in the artery wall. 
• Radiation therapy: High dose radiation to the chest during cancer treatment can damage heart valves.

Several factors can increase your risk of developing aortic valve disease. These include:

• Age: Your risk of aortic valve disease increases significantly with age, as the valve naturally wears down over time.
• Birth defects: Being born with a heart defect, especially a bicuspid aortic valve.
• High cholesterol: Untreated high cholesterol can cause plaque buildup that can affect the valve.
• Certain infections: Infections like rheumatic fever can damage your heart valves.
• Connective tissue disorders: Conditions like Marfan Syndrome or Turner Syndrome are known to increase the risk of aortic valve problems.
• Long-term kidney disease
• Substance abuse: Intravenous drug use can increase the risk of infective endocarditis, which can damage the heart valves.

It's important to note that having one or more of these risk factors doesn't guarantee you'll develop aortic valve disease, but it does increase your likelihood. Regular checkups with your doctor, especially if you have a family history or other risk factors, are crucial for early detection and management.

Aortic valve disease screening and diagnosis

Your AHN cardiologist has the experience and skill to accurately screen for and diagnose aortic valve disease. Your AHN doctor will diagnose aortic valve disease with a checkup and some tests. This screening and diagnosis often include:

• Asking about your health history.
• Checking your heart rate, blood pressure, and breathing.
• Listening to your heart with a stethoscope. A whooshing sound (a murmur) might mean you have aortic valve disease.
• Using an electrocardiogram (ECG) test to check your heart's rhythm and electrical activity.

Primary test: Echocardiogram

If the doctor notices any signs of aortic valve disease during your appointment, you will be referred for an echocardiogram. This test uses sound waves to take pictures of your heart. It will give important information about blood flow and pressure in your heart (hemodynamic measurements). It might be determined that you need other tests so your care team can get a more detailed view of your aortic valve. These other tests may include:

• Chest X-ray: This shows pictures of your heart and lungs.
• Cardiac catheterization: A thin, flexible tube is inserted into your heart through a blood vessel to measure pressure inside your heart.
• Cardiac MRI or CT scan: This test uses radiofrequency waves and magnets to create 3D images and real-time videos of your heart and circulatory system. Learn more about cardiac MRI or CT scan.
• Exercise stress test: An exercise stress test shows how well your heart works when it's under pressure. You'll gradually exercise (like walking on a treadmill) while the doctor watches your heart rate, blood pressure, and ECG (heart's electrical activity).

Types of aortic valve disease

If it’s determined that you have aortic valve disease, your doctor will help you understand the specific type. There are four main types of aortic valve disorders that cause blood to either flow backward or restrict the amount of oxygenated blood flowing through your body:

• Aortic stenosis: In this common condition, the opening to the aortic valve becomes narrow, making it harder for blood to flow through.
• Aortic regurgitation or insufficiency: When the aortic valve doesn’t close correctly, blood leaks backward in the heart, reducing the amount of oxygenated blood going to your body. This is sometimes called a leaky aortic valve.
• Bicuspid aortic valve disease: In this case, the aortic valve only has two flaps instead of its usual three. This anatomical condition is present at birth, often referred to as a congenital condition. It is common – found in 1% to 2% of the US population. If complications arise — such as heart failure, aortic stenosis, or aortic regurgitation — the condition changes from a structural one to a disease and requires management to monitor, treat and possibly perform surgery.
• Infective endocarditis: This serious condition causes the heart’s aortic valve to become inflamed, usually caused by an infection within the body.

Aortic valve disease treatment

Treatment depends on the type and severity of the disease, and your overall health. Your treatment will be tailored to your needs and your care team will help you navigate your tailored treatment plan using care coordination that, if needed, extends to different areas of medicine. Often aortic valve treatment includes:

• Medicine: For mild cases, medicines help lower the chance of complications. These could include drugs to reduce fluid buildup, help your heart work better, or prevent blood clots.
• Surgery: For moderate to severe cases, surgery is often needed. These procedures use newer techniques that are less invasive and cause less scarring (minimally invasive surgery). This could include:
  • Valvuloplasty: Using a small balloon to open the aortic valve.
  • Aortic valve repair: Fixing the valve without replacing it.
  • Aortic valve replacement: Replacing the valve with an artificial one. This is called transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI).

Living with aortic valve disease means regular checkups and following your doctor's advice. A healthy lifestyle helps, too. Early diagnosis and treatment give you the best chance for a good outcome.

Aortic valve disease FAQs

Having an understanding of aortic valve disease and how it may affect you can help you in navigating your care and treatment plan. Your AHN care team is available to answer any and all questions you have about the disease and any procedures you may need. To help you get an understanding, and feel confident in your care, we’ve included some of our patients’ most frequently asked questions. You can use these in your discussions with your AHN care team.

What is the life expectancy of someone with aortic valve disease?

The life expectancy of someone with aortic valve disease varies significantly depending on several factors, including the type and severity of the disease, the presence of symptoms, the individual's overall health, and whether they receive appropriate treatment.

• Asymptomatic, mild to moderate aortic stenosis: Many individuals can live for many years without significant symptoms or progression. However, regular monitoring is crucial.
• Symptomatic, severe aortic stenosis: Without treatment, the prognosis is often poor, with an average life expectancy of 2 to 3 years once symptoms like chest pain, shortness of breath, or fainting occur.
• Treated aortic valve disease: With successful treatment, such as valve replacement or repair, life expectancy can be significantly improved, often approaching that of the general population, although long-term follow-up is always necessary.

How serious is aortic valve disease?

Aortic valve disease can range in seriousness from mild to life-threatening.

• Mild cases: In some instances, particularly with mild forms of aortic stenosis or regurgitation, the condition may be stable for years with minimal impact on daily life and can be managed with monitoring.
• Moderate to severe cases: As the disease progresses, it can lead to serious complications including heart failure, irregular heart rhythms (arrhythmias), stroke, and sudden cardiac death. The severity is often determined by how much the valve is narrowed (stenosis) or leaks (regurgitation) and the presence of symptoms.
• Untreated severe cases: If severe aortic valve disease is left untreated, it can lead to irreversible heart damage and significantly reduce life expectancy.

Can aortic valve disease be treated?

Yes, aortic valve disease can be treated. The treatment approach depends on the type, severity, and symptoms of the disease, as well as the patient's overall health.

• Monitoring: For mild cases without symptoms, regular monitoring with echocardiograms is often sufficient.
• Medications: While medications cannot fix a damaged valve, they can manage symptoms and complications such as high blood pressure, fluid retention, or irregular heartbeats.
• Aortic Valve Replacement (AVR): This is the most common and effective treatment for severe aortic valve disease.
• Surgical Aortic Valve Replacement (SAVR): An open-heart surgery where the damaged valve is replaced with a mechanical or biological (tissue) valve.
• Transcatheter Aortic Valve Replacement (TAVR): A minimally invasive procedure where a new valve is delivered through a catheter, often through an artery in the leg, and deployed within the old valve. This is often preferred for older patients or those with higher surgical risk.
• Aortic valve repair: In some specific cases, especially with aortic regurgitation, the valve may be repaired rather than replaced.

Does aortic valve disease run in families?

Yes, in some cases, aortic valve disease can have a genetic component and run in families.

• Bicuspid Aortic Valve (BAV): This is the most common congenital heart defect, where the aortic valve has two leaflets instead of the usual three. BAV is often inherited, and family members of an individual with BAV have an increased risk of also having the condition. BAV increases the risk of developing aortic stenosis or regurgitation later in life, as well as aortic dilation or aneurysm.
• Genetic Syndromes: Certain genetic syndromes, such as Marfan syndrome or Loeys-Dietz syndrome, can also predispose individuals to aortic valve disease and aortic root dilation, which are inherited conditions.
• General Risk Factors: While not directly inherited, certain risk factors for aortic valve disease, like high blood pressure or high cholesterol, can have a familial predisposition, indirectly increasing the risk.

Contact us

If you are navigating an aortic valve condition, AHN is here to help. We have numerous locations, so you can seek care closer to home.

Undiagnosed

If you have not been formally diagnosed yet, call (412) DOCTORS 412-362-8677 to schedule an appointment with a general cardiologist to be evaluated.

Seeking a second opinion

If you’re already diagnosed with an aortic disease and you are seeking a second opinion, call 1-855-828-TAVR 1-855-828-8287 to schedule a consultation with our Aortic Disease Program.

Connect with the Aortic Disease Program

To schedule a consultation with our Aortic Disease Program, call 1-855-828-TAVR 1-855-828-8287 and connect with our program coordinator.

Scheduling a procedure

If you have a referral to schedule a procedure, contact the team at the facility where you want to have the procedure completed: