Bicuspid aortic valve disease (BAVSD) is a group of disorders that affect the heart. The aortic valve is a part of the heart that normally has three cusps (also called leaflets) that manages the blood flow in the heart's left ventricle. The Cedars-Sinai Heart Institute explains that people who are born with BAVD only have two leaflets in the aortic valve, which can cause a variety of medical problems over time. Medical experts at Cedars-Sinai estimate that up to 2 percent of all people may have a bicuspid aortic valve.
Types of BAVD
There are two types of BAVD that can cause stress to a person's heart. Bicuspid aortic valve insufficiency occurs when the aortic valves do not close as tightly as they should. The weak, or insufficient valves allow blood back into the heart, a condition called regurgitation or leakage. Regurgitation, due to a weakened bicuspid valve, puts additional strain on the heart because the muscle must work harder to re-pump the blood out to the body. Insufficiency of this kind can be repaired through surgery, but sometimes is not successful if the leakage has been going on for a long period of time.
Bicuspid aortic valve stenosis is the narrowing of the deformed valve. Deposits of calcium may make the valves smaller than normal, and unable to open as fully as a normally formed aortic valve. Additional stress is placed on the heart's left ventricle as it works overtime to pass blood through the narrowed valves. The Bicuspid Aortic Foundation (BAF) explains that people with early bicuspid aortic valve stenosis may feel the strain during physical exertion, but not during periods of rest.
Signs
Some people who have BAVD may not feel any symptoms of the disease. Others may more likely to develop a heart valve infection called endocarditis, high blood pressure and aneurysms. Organs throughout the body may be affected by BAVD, according to the Bicuspid Aortic Foundation. Liver and kidney cysts are two signs that may be consistent with BAVD. For reasons that are unknown, people with BAVD may also be nearsighted.
Diagnosis
BAVD is diagnosed mainly though imaging testing. The BAF reports that some physicians may be able to detect regurgitation when listening to a patient's chest through a stethoscope, but this is not always a reliable diagnostic tool. CAT scans, ultrasounds and magnetic resonance imaging (MRI) may all be used to identify the shape of the heart's valves and to determine the damage that may have resulted from this congenital defect.
Treatment
BAVD may be treated through medication and surgery. Medications such as ACE inhibitors and beta blockers are prescribed to lower blood pressure and reduce leakage. Self-care measures are recommended in conjunction with medical intervention and include following a healthy diet and exercise plan to reduce the risk of further heart disease. Weight lifting is not recommended as a form of exercise because of the undue strain that is placed on the aortic valve.
Valve replacement surgery may be performed to counter the damage sustained from a bicuspid aortic valve. Valves that do not need to be completely replaced may be repaired in order to correct stenosis, or the narrowing of the valve.
Prevention of Complications
People with BAVD are more susceptible to infection and must take precautions to avoid complications that can become dangerous to their health. Patients with heart valve defects should take antibiotics prior to routine tooth cleaning appointments as well as extensive dental work to prevent infection. Minor medical procedures, such as biopsies or the removal of a mole, should also be treated with a preventive dose of antibiotic medications.
