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Definition

Aortic Valve Disease entails damage to, and dysfunction of, the aortic valve, one of the four valves in the heart.

Overview​

The most common valvular problem in old age is aortic valve disease.

The aortic valve is one of four valves that control the flow of blood into and out of the heart. In particular, 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.

Types of aortic valve disease include:

  • Aortic Stenosis: The valve is abnormally narrow (aortic stenosis) and the heart must work harder for a sufficient amount of blood to be pumped with each beat.  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 the 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: 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.  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.

In either Aortic Stenosis or Regurgitation, 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).