Valvular heart disease

There are 4 valves within the heart, which perform important functions to allow blood to flow forward freely and prevent backward flow. When a valve becomes narrowed, this is called valve “stenosis”. When a valve becomes leaky, this is called valvular “regurgitation”.Watch the video in the link below for an explanation of how valves work and what problems can occur with heart valves.

Stenosis or regurgitation of a valve may cause a “heart murmur” which is a sound which can be heard with a stethoscope on the outside of the chest. This is caused by turbulent blood flow within the heart. It is important to know that some people may have heart murmurs which are not of concern, such as young people or pregnant women, where blood flow can be brisk and somewhat turbulent.An echocardiogram (ultrasound of the heart) is the main test used to assess a heart murmur or suspected heart valve disease. The test can be very useful in detecting valve stenosis or regurgitation, and assessing the significance and severity of these problems. Depending on the valve involved and degree of narrowing/leakiness, you may need monitoring with periodic echocardiograms, or may require other forms of testing. There are often effective treatments for valve disease.

Aortic stenosis

Aortic stenosis is often a disease that develops in older age, due to calcium build up within the aortic valve leaflets, leading to restriction in leaflet opening. This can lead to symptoms, including breathlessness, chest pain and lightheadedness with exertion. Some patient with a bicuspid aortic valve may develop aortic stenosis at a younger age.

Regular examinations and echocardiograms can be used to monitor the severity of the narrowing.
In the past, the main treatment option for aortic stenosis was open heart surgery in order to replace the aortic valve. However, in many cases, aortic stenosis can now be treated with TAVI (Transcatheter Aortic Valve Implantation). The decision around which of these treatments is most suitable depends upon your other medical issues and the results of a number of tests. In some situations where the risk of either procedure may be too high, you may require supportive treatment and medication alone.

Bicuspid aortic valve

A bicuspid aortic valve is a valve with 2, rather than 3, leaflets. This is a fairly common condition within the community and is inherited.

A bicuspid aortic valve can become narrowed or leaky at a fairly young age. Enlargement or narrowing (coarctation) of the aorta, the main blood vessel carrying blood from the heart to the body, can also occur with this condition. Monitoring with echocardiography is recommended for this condition, to detect any problems with the valve or aorta that may develop over time.

Echocardiographic screening is also recommended for anyone with a first degree relative (parent, sibling or child) found to have this issue. This is to determine whether family members also have a bicuspid valve and need monitoring over time.