Complications of Bicuspid Aortic Valve
The most common congenital heart disorder, bicuspid aortic valve (BAV), impacts both the aortic valve (which controls the flow of blood into the aorta) and the thoracic aorta (the major vessel that sends blood throughout the body), making blood flow irregular. Complications of the disease can be life-threatening so early diagnosis is essential.
Team Approach to Treating Bicuspid Aortic Valve
At Northwestern Memorial’s Center for Heart Valve Disease, we believe a multidisciplinary approach leads to more successful treatment of heart disease. Our expert team of cardiologists, cardiac surgeons, nurses, cardiac rehabilitation specialists, psychologists and social workers in the Bicuspid Aortic Valve Program collaborates to help patients diagnose and manage BAV. During your care, a dedicated nurse coordinator will follow your case and help coordinate the team.
Symptoms and Complications of Bicuspid Aortic Valve
Less than five percent of people with BAV—when closely followed—will develop complications from the disease. Those who do have complications may experience:
- Trouble breathing
- Chest pain or pressure
- Heart racing
Patients with BAV may experience any of these complications:
- Aortic stenosis: The aortic valve does not open wide enough, causing restricted blood flow
- Aortic regurgitation/insufficiency: The aortic valve does not close completely, causing the valve to leak
- Infective endocarditis: Bacteria or other organisms create an infection of heart valves and the heart lining
- Aortic aneurysm: The vessel wall of the aorta balloons outward
- Coarctation of the aorta: The aorta becomes too narrow along an edge
Aortic Stenosis and Aortic Regurgitation/Insufficiency
In patients with aortic stenosis and/or aortic regurgitation/insufficiency, the heart weakens as it struggles to perform efficiently with a valve that is not working properly.
We treat most patients with aortic stenosis and/or aortic regurgitation/insufficiency who do not have symptoms with medical management. We educate patients on good oral hygiene, a heart-healthy diet, benefits of quitting smoking, and treating high blood cholesterol. We also strive to:
- Slow disease progression
- Prevent disease complications
- Recognize symptom onset quickly
- Identify optimal timing of surgical intervention
When a BAV patient begins to feel symptoms, surgery may be needed to relieve symptoms and prolong life. Continued medical management without surgical intervention is appropriate only for patients who are too high-risk for surgical intervention.
Endocarditis is an infection of the heart that affects the heart valves and the endocardium (the lining of the heart), usually caused by bacteria. Infective endocarditis may be difficult to treat and potentially life-threatening.
Endocarditis may cause mild symptoms that may be ignored by a patient or undetected by a healthcare provider. In some patients, the opposite is true. The bacteria are aggressive, and the patient becomes severely ill immediately. Symptoms may include:
- Weakness, achiness
- Fever, chills
- Sore throat
- Rapid and/or irregular heartbeat
- Trouble breathing
- Persistent cough
We may use intravenous antibiotic therapy for four to six weeks or more to treat endocarditis. Severe cases may require surgical replacement of infected valves.
Disorders of the Aortic Wall
BAV is associated with disorders of the aortic wall, including aortic root aneurysm, ascending aortic aneurysm and coarctation of the aorta.
For patients with BAV, disorders of the aortic wall occur at a significantly higher rate and earlier in life, compared to those with healthy heart valves. Surgery for these patients is essential for ensuring long life.
Disorders of the aortic wall can occur in any patient with BAV, including those who have had aortic valve replacement. Because of this, your health care provider should monitor the size and shape of the aorta after a BAV diagnosis and throughout your lifetime.
Medical management with beta-blocking medication (which slows the heart rate and softens the heart beat) may be effective in slowing the progression of aortic wall disorders.
Patients with aortic wall disorders are at risk for a type of aortic wall disorder called aortic dissections: bleeding into and along the wall of the aorta. Aortic dissections can occur with no warning and require immediate surgery. Symptoms of an aortic dissection include:
- Chest pain
- Shortness of breath
- Abdominal pain
- Leg pain
If you have BAV and are experiencing any of these symptoms, call 911 or go to your nearest emergency department immediately.
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