Aortic Valve Disease
What is It?
The aortic valve controls blood flow from the main pumping chamber of the heart (left ventricle) to the rest of the body through the aorta. In aortic valve disease, the valve has become narrowed (stenosis) or started to leak (regurgitation). Aortic valve disease is the most common form of valvular heart disease, particularly in older adults, affecting up to 10% of people over 75. Without treatment, severe disease can lead to heart failure and death.
What are the symptoms?
Many patients with aortic valve disease have no symptoms for years. As the disease progresses, symptoms include shortness of breath (especially on exertion), chest pain or tightness, dizziness or fainting (particularly with exertion), fatigue, heart palpitations, and swelling of the ankles and feet. Sudden, severe chest pain requires immediate medical attention.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of aortic valve disease. Causes include:
- Age-related calcification: The most common cause, where calcium deposits cause the valve leaflets to stiffen and narrow.
- Congenital bicuspid aortic valve: A valve with two leaflets instead of three, which is prone to early degeneration.
- Rheumatic fever: A complication of untreated streptococcal infection that can damage heart valves.
- Infective endocarditis, radiation therapy, and connective tissue diseases such as Marfan syndrome.
How is it investigated?
Initial diagnosis is often made on examination after a detailed history. Your One Heart Centre cardiologist will arrange an echocardiogram to confirm the diagnosis and assess severity. Cardiac CT and cardiac MRI are frequently used as part of the diagnostic pathway. A transoesophageal echocardiogram (TOE) may be required for detailed assessment, and cardiac catheterisation may be performed prior to intervention.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing aortic valve disease and will provide a personalised treatment plan for your aortic valve disease. Treatment depends on the type and severity of disease and includes:
- Surveillance: Mild to moderate disease is monitored with regular echocardiograms.
- Medical therapy: Medications to manage symptoms and associated conditions, though medications cannot reverse structural valve disease.
- Surgical aortic valve replacement (SAVR): Traditional open-heart surgery using mechanical or biological valves.
- Transcatheter aortic valve implantation (TAVI): A minimally invasive, catheter-based procedure offering shorter recovery times, particularly suitable for higher-risk patients.