Valve Diseases

Aortic Valve Diseases

Aortic Regurgitation
Aortic Regurgitation (also called Aortic Insufficiency or Aortic Incompetence) is a condition in which blood flows backward from a widened or weakened Aortic valve into the left ventricle (lower chamber). In its most serious but less common form, Aortic Regurgitation is caused by an infection that leaves holes in the valve leaflets.

Causes
Aortic Regurgitation is more common in men aged 30 to 60 years old. In adults, the most common cause of severe Aortic Regurgitation is Rheumatic fever. Mild cases are often associated with a bicuspid aortic valve and severe hypertension (Diastolic pressure greater than 110 mg/Hg). Other causes, though rare, may include:

Marfan syndrome, a degenerative connective tissue condition characterized by long bones and hyperflexible joints.
Endocarditis.
Ankylosing spondylitis, a condition that causes inflammation of the joints between the Vertebrae and Spine, and the Spine and the Pelvis.
Dissecting Aortic aneurysm.
Aortic Stenosis, a narrowing of the aortic valve that is often associated with some degree of Aortic regurgitation.

Symptoms
Like other Valve defects, symptoms may not appear for years. When they do appear, they can come on gradually or suddenly. Symptoms result from the left ventricle’s having to work harder: the ventricle eventually enlarges and fluid backs up. Symptoms may include:

Shortness of breath.
Chest pain that increases with exercise and subsides with rest.
Swelling in the ankles.
Fatigue.
Rapid or fluttering pulse.

Severe cases can lead to heart failure. In most of these cases, the Aortic valve will eventually need to be replaced to correct the backflow of blood into the left ventricle.

Aortic Stenosis
Aortic Stenosis is a narrowing or obstruction of the Aortic valve, which regulates blood flow from the left ventricle (lower left chamber) into the aorta, as it passes on to the rest of the body. The valve leaflets become coated with deposits that distort their shape and reduce blood flow through the valve. The left ventricle works harder to compensate for the reduced blood flow, but over time, the extra exertion can weaken the heart muscle.

Causes
Aortic Stenosis is more common among men. Congenital (Inherited) defects and Rheumatic fever account for the majority of cases in persons under 50. Some persons are born with a Bicuspid Aortic valve (2 valve leaflets instead of 3), which also may cause Aortic Stenosis. In elderly patients, calcium deposits and fibrosis (the growth of fibrous tissue) on the aortic valve can distort the leaflets or cause them to fuse together. Severe Calcification may make the leaflets almost unrecognizable. Other causes include a history of other Valve diseases, Coronary Artery disease or Heart murmur.

Symptoms
Persons with Aortic stenosis may feel no symptoms for years. When symptoms do appear, they may include:

Fainting, especially during exercise.
Angina–like chest pain that increases with exercise and subsides with rest.
Shortness of breath.
Heart palpitations.
Coughing.

Patients who have Aortic stenosis are advised to avoid strenuous exercise. Those with mild Aortic stenosis may not require any further treatment other than observation. Surgical replacement of the valve is the treatment of choice for Symptomatic Aortic stenosis.

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