Aortic Valve Disease

The aortic valve is located between the left heart chamber and the aorta. The aortic valve may get narrowed ( stenotic) due to rheumatic endocarditis or due to bacterial endocarditis. Arteriosclerosis (hardening of the artery) from aging of the aorta can also affect the aortic valve and lead to a leaky valve (aortic insufficiency).

These patients may present with tiredness or some breathlessness with exercise or when walking stairs. This could go on for many years until suddenly one day the balance tips and they become acutely symptomatic. Now they present with symptoms such as air hunger, left sided chest pains and dizziness.

The skin color may be pale. The physician examining the patient will detect pathological heart sounds and murmurs on auscultation which assists with all the other signs and symptoms to lead to a diagnosis.

A referral to a cardiologist will be the next step and further tests ordered by the specialist such as an echocardiogram (which are Doppler studies of the structures of the heart), X rays and possibly heart catheterization with angiocardiography will pinpoint the exact diagnosis. Following this the cardiologist can formulate a rational treatment plan involving either surgery, medication or a combination of both. In the last few years much has been gained in this field and even heart transplantation has become a feasible alternative for the end stage of CHF. In the past this meant almost always certain impending death.

Other Heart Valves

There are two more heart valves in the right heart chamber (the tricuspid and the pulmonary valves) which can also get diseased. These abnormalities are much less common. Congenital heart valve abnormalities are not uncommon including variations of heart valves such as the mitral valve prolapse and other defects. These are beyond the scope of this book. However, the family physician can do an initial assessment and refer the affected patient to the appropriate specialist.

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Cardiovascular disease

Heart valve disease

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapters 197, 202, 205 and 207.

2. Braunwald: Heart Disease: A Textbook of Cardiovascular Medicine, 6th ed., 2001, W. B. Saunders Co.

3. D C Bauer: Audio-Digest Family Practice Vol. 49, Iss. 09, March 2, 2001.

Last Modified: Nov.3, 2006