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Aortic valve disease

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Overview

Aortic valve disease is a condition in which the valve between the main pumping chamber of your heart (left ventricle) and the main artery to your body (aorta) doesn't work properly. Aortic valve disease may be a condition present at birth (congenital heart disease), or it may result from other causes.

Types of aortic valve disease include:

Aortic valve stenosis

  • Aortic valve stenosis

    Aortic valve stenosis

    Aortic valve stenosis

    Aortic valve stenosis is a defect that narrows or obstructs the aortic valve opening, making it difficult for the heart to pump blood into the aorta. This may not have symptoms initially, but it can worsen over time. Typically the aortic valve has three cusps (tricuspid aortic valve), but some people are born with an aortic valve that has two cusps (bicuspid aortic valve).

In this condition, the flaps (cusps) of the aortic valve may become thickened and stiff, or they may fuse together. This causes narrowing of the aortic valve opening. The narrowed valve isn't able to open fully, which reduces or blocks blood flow from your heart into your aorta and the rest of your body.

Aortic valve regurgitation

  • Aortic valve regurgitation

    Aortic valve regurgitation

    Aortic valve regurgitation

    In aortic valve regurgitation, the aortic valve doesn't close properly, causing blood to leak backward from the aorta into the left ventricle.

In this condition, the aortic valve doesn't close properly, causing blood to flow backward into the left ventricle.

Your treatment depends on the type and severity of your aortic valve disease. In some cases you may need surgery to repair or replace the aortic valve.

Aortic valve disease care at Mayo Clinic

Symptoms

Some people with aortic valve disease may not experience symptoms for many years. Signs and symptoms of aortic valve disease may include:

  • Abnormal heart sound (heart murmur) heard through a stethoscope
  • Shortness of breath, particularly when you have been very active or when you lie down
  • Dizziness
  • Fainting
  • Chest pain or tightness
  • Irregular heartbeat
  • Fatigue after being active or having less ability to be active
  • Not eating enough (mainly in children with aortic valve stenosis)
  • Not gaining enough weight (mainly in children with aortic valve stenosis)

When to see a doctor

If you have a heart murmur, your doctor may recommend that you visit a cardiologist or have a test called an echocardiogram (ultrasound of the heart). If you develop any symptoms that may suggest aortic valve disease, see your doctor.

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Causes

  • Chambers and valves of the heart

    Chambers and valves of the heart

    Chambers and valves of the heart

    A normal heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood out of your heart. The heart valves, which keep blood flowing in the right direction, are gates at the chamber openings.

  • Narrowing of aortic valve in aortic valve stenosis

    Aortic valve stenosis

    Aortic valve stenosis

    In aortic valve stenosis, there is progressive narrowing of the aortic valve opening over time (top row), which results in increased pressure within the heart and reduced capacity to pump blood to the body. This is similar to attaching smaller and smaller nozzles to the end of a garden hose (bottom row). The narrowing from the nozzle slows the forward flow of water and results in progressive pressure buildup within the garden hose.

Your heart has four valves that keep blood flowing in the correct direction. These valves include the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Each valve has flaps (cusps or leaflets) that open and close once during each heartbeat. Sometimes, the valves don't open or close properly, disrupting the blood flow through your heart and potentially impairing the ability to pump blood to your body.

In aortic valve disease, the aortic valve between the lower left heart chamber (left ventricle) and the main artery that delivers blood from the heart to the body (aorta) doesn't work properly. It may not be closing properly, which causes blood to leak backward to the left ventricle (regurgitation), or the valve may be narrowed (stenosis).

Aortic valve disease may be caused by a heart defect present at birth (congenital). It can also be caused by other conditions, including age-related changes to the heart, infections, high blood pressure or injury to the heart.

Risk factors

Risk factors of aortic valve disease include:

  • Older age
  • Certain heart conditions present at birth (congenital heart disease)
  • History of infections that can affect the heart
  • Chronic kidney disease
  • History of radiation therapy to the chest

Complications

Aortic valve disease can cause complications, including:

  • Heart failure
  • Stroke
  • Blood clots
  • Heart rhythm abnormalities
  • Death

By Mayo Clinic Staff

Aortic valve disease care at Mayo Clinic

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Diagnosis & treatment
Jan. 09, 2020
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  1. Bonow RO, et al., eds. Aortic valve disease. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Saunders Elsevier; 2019. https://www.clinicalkey.com. Accessed Aug. 7, 2019.
  2. Buji LM, et al., eds. Valvular heart disease. In: Cardiovascular Pathology. 4th ed. Elsevier Academic Press; 2016. https://www.clinicalkey.com. Accessed Aug. 7, 2019.
  3. Crawford MH, ed. Aortic stenosis. In: Current Diagnosis & Treatment: Cardiology. 5th ed. McGraw-Hill Education; 2017. https://accessmedicine.mhmedical.com. Accessed Aug. 7, 2019.
  4. Crawford MH, ed. Aortic regurgitation. In: Current Diagnosis & Treatment: Cardiology. 5th ed. McGraw-Hill Education; 2017. https://accessmedicine.mhmedical.com. Accessed Aug. 7, 2019.
  5. Fuster V, et al., eds. Aortic valve disease. In: Hurst's the Heart. 14th ed. McGraw-Hill Education; 2017. https://accessmedicine.mhmedical.com. Accessed Aug. 7, 2019.
  6. National Heart, Lung, and Blood Institute. Heart-healthy lifestyle changes. https://www.nhlbi.nih.gov/health-topics/heart-healthy-lifestyle-changes. Accessed Aug. 15, 2019.

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