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Aortic valve disease aortic insufficiency aortic aneurysm causes of aortic aneurysm symptoms of aortic aneurysm complications of aortic aneurysm diagnosis of aortic aneurysm treatment for aortic aneurysms abdominal aortic aneurysm (AAA) symptoms of abdominal aortic aneurysm diagnosis of abdominal aortic aneurysm treatment for abdominal aortic aneurysm aortic valve regurgitation causes of aortic valve regurgitation symptoms of aortic regurgitation diagnosis of aortic valve regurgitation treatment for aortic regurgitation aortic valve stenosis causes of aortic stenosis symptoms of aortic stenosis diagnosis of aortic stenosis treatment for aortic stenosis aortic valve replacement surgery other heart valve disorders {mitral valve disease mitral valve prolapse mitral valve regurgitation mitral stenosis mitral valve repair and replacement pulmonic valve stenosis tricuspid regurgitation tricuspid stenosis heart valve replacement and repair}

Aortic valve disease

The aortic valve is one of the valves of the heart. It lies between the left ventricle and the aorta. During ventricular systole, pressure rises in the left ventricle. When the pressure in the left ventricle rises above the pressure in the aorta, the aortic valve opens, allowing blood to exit the left ventricle into the aorta. When ventricular systole ends, pressure in the left ventricle rapidly drops. When the pressure in the left ventricle decreases, the aortic pressure forces the aortic valve to close. The closure of the aortic valve contributes the A2 component of the second heart sound (S2).

An aortic valve may be abnormal at birth: although this valve normally has three cusps it sometimes has two. This does not cause problems until later in life when it may become narrowed and cause aortic stenosis. Another defect at birth can cause aortic regurgitation later. These defects may be found at birth but aortic stenosis or regurgitation may also be caused later by rheumatic fever. There are also several other causes of aortic regurgitation. It may occur with joint diseases such as rheumatoid arthritis, ankylosing spondylitis, and a rarer condition called Reiter's syndrome. It may also occur with the skin condition psoriasis and as a long-term complication of syphilis. This is now rare. Infection on an abnormal aortic valve leads to a disease called infective endocarditis. This usually produces or causes a worsening of any leaking of the valve.

The aortic valve controls the flow of oxygenated blood pumped out of the heart from the left ventricle into the aorta, the main artery leading to the rest of the body. If the valve is abnormally narrow (aortic stenosis), the heart must work harder for a sufficient amount of blood to be pumped with each beat. On the other hand, if the valve does not close properly, it may cause aortic regurgitation because some of the blood being pumped out into the aorta regurgitates, or leaks backward, into the left ventricle with each beat. In either case, the work of the ventricle increases. As a result, its muscular wall thickens (a condition known as hypertrophy) and the left ventricle may become larger (dilate). Aortic stenosis refers to the process of thickening and stiffening in the valve. The valve itself, however, may continue to function adequately for years, with nothing more than a heart murmur heard by the physician on examination with a stethoscope. The murmur is caused by turbulence of blood passing through the valve. In aortic stenosis, the aortic valve becomes narrowed and blocked by hard, calcified deposits, or in some people, from rheumatic fever years earlier. This condition is present in about 4 percent of all elderly people. Severe aortic valve stenosis can cause fainting (because of impaired blood flow to the brain across the narrowed valve); heart failure and shortness of breath (when the heart's muscle becomes unable to pump blood in a forward direction through narrow opening); and chest pain (because of increased work and a lack of sufficient oxygen reaching heart muscles). Aortic regurgitation is usually asymptomatic until middle age. Patients may present with heart failure or chest pain. Some causes of aortic regurgitation include congenitally bicuspid (only two cusps instead of three) valves, infective endocarditis, and high blood pressure.

An aortic valve disorder usually does not cause any symptoms in its early stages. As the problem progresses, it may produce shortness of breath, angina (chest pain), light-headedness, dizziness, and even fainting, especially upon exertion. Many elderly people with aortic stenosis remain free of symptoms. Most cases of aortic valve disease can be diagnosed by a physical examination, during which a characteristic heart murmur may be detected. A chest X-ray, an electrocardiogram (EKG, to determine whether the heart is enlarged), and an echocardiogram (ultrasound study of heart muscle and valves) also may be done. If enough physical symptoms are present, cardiac catheterization may be necessary to better evaluate the valve and heart function.

A mild valve abnormality needs no treatment. The symptoms of heart failure (breathlessness and ankle swelling) need medication called diuretics. These get rid of the excess fluid that the kidneys retain and you pass more urine. If this treatment is not enough or if the valve defect (particularly stenosis) poses any threat, valve replacement surgery must be considered. Regular check-ups are important to make sure that the valve defect and its effect on the heart's pumping does not become dangerous. If you get breathless, you should seek advice. Treatment may need to be started or increased. If you have aortic stenosis (narrowing), a blackout or dizziness may mean some deterioration has occurred. You should then see your doctor as soon as possible. If germs get into the bloodstream there is a risk of getting infection on an abnormal aortic valve. This is called infective endocarditis. Germs get into the blood through the gums after dental treatment or with other operations or investigations which use instruments passed inside the body. Prevention, by taking antibiotics, is better than cure. They are given, usually by mouth, an hour before dentistry or an operation. You should carry a card with all the details. Show it to any doctor or dentist treating you.

Aortic stenosis may eventually cause blackouts or even sudden death. Regular check-up is essential to ensure that it does not get worse. If the condition is severe it is extremely important to have a new valve inserted. For aortic regurgitation, regular checks are also important to make sure that the heart is not strained. This may happen even with mild symptoms. If valve surgery is left too late, it may then be too late to make any difference to your symptoms or outlook.

More information on aortic valve diseases

What is aortic valve disease? - An aortic valve disorder usually does not cause any symptoms in its early stages. Infection on an abnormal aortic valve leads to a disease called infective endocarditis.
What is aortic insufficiency? - Aortic insufficiency is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole.
What is an aortic aneurysm? - An aortic aneurysm is a localized dilatation or aneurysm of the aorta, usually representing an underlying weakness in the wall of the aorta at that location.
What causes an aortic aneurysm? - Most aortic aneurysms occur in the abdominal aorta, the main cause being arteriosclerosis. There is a familial tendency to aortic aneurysms.
What're the symptoms of aortic aneurysm? - Most intact aortic aneurysms do not produce any symptoms. The ballooning of the aneurysm does not cause any symptoms unless it becomes large enough.
What're the complications of aortic aneurysm? - Half of all persons with untreated abdominal aortic aneurysms die of rupture within 5 years. Spontaneous blockage of the aorta can also occur.
How is aortic aneurysm diagnosed? - Aortic aneurysms can be diagnosed from their symptoms. An ultrasound scan is the easiest way to detect an aortic aneurysm.
What's the treatment for aortic aneurysms? - Medical therapy of aortic aneurysms involves strict blood pressure control. Symptomatic aneurysms require surgical treatment to prevent complications.
What's an abdominal aortic aneurysm (AAA)? - An abdominal aortic aneurysm (AAA) is a bulge in the aorta in abdomen. Most AAAs occur in association with advanced atherosclerosis.
What're the symptoms of abdominal aortic aneurysm? - Symptoms of abdominal aortic aneurysm include a pulsing sensation in the abdomen, and pain ranging from mild to severe.
How is abdominal aortic aneurysm diagnosed? - Because abdominal aortic aneurysms may not cause any symptoms at the beginning, they are diagnosed by chance during a physical examination.
What's the treatment for abdominal aortic aneurysm? - Treatment of abdominal aortic aneurysm depends upon the size of the aneurysm. Surgical treatment of abdominal aortic aneurysm is often preformed.
What's aortic valve regurgitation? - Aortic valve regurgitation develops hen the valve leaflets fail to close properly during the heart's relaxation phase.
What causes aortic valve regurgitation? - Causes of aortic valve regurgitation include being born with a defective aortic valve, wear and tear from aging, infection of the lining of the heart.
What're the symptoms of aortic regurgitation? - Symptoms of aortic regurgitation include chest pain, excessive sweating, palpitations, shortness of breath that worsens with exertion or lying down.
How is aortic valve regurgitation diagnosed? - A doctor diagnoses aortic valve regurgitation by hearing a heart murmur or other abnormal noises when listening with a stethoscope.
What're the treatments for aortic regurgitation? - Medicines to improve the pumping action of the heart may be given to reduce the severity of the regurgitation. Valve replacement surgery is usually recommended.
What is aortic stenosis? - Aortic valve stenosis is a heart condition caused by narrowing of the aortic valve. Aortic stenosis is the inability of the aortic valve to open completely.
What causes aortic stenosis? - Congenital aortic stenosis is caused by improper development of the aortic valve in the first 8 weeks of fetal growth. Age related calcification of the valve is the most common cause.
What're the symptoms of aortic stenosis? - Symptoms of aortic stenosis include shortness of breath (dyspnea), passing out (syncope), and chest pain (angina pectoris).
How is aortic stenosis diagnosed? - Aortic stenosis is often diagnosed due to the presence of a heart murmur. The gold standard for diagnosis is an echocardiogram.
What's the treatment for aortic stenosis? - Patients with mild aortic stenosis do not require treatment. Valve replacement surgery is indicated for patients with severe aortic stenosis.
Aortic valve replacement surgery - Aortic valve replacement surgery is an open heart procedure for treatment of narrowing (stenosis) or leakage (regurgitation) of the aortic valve.
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