About Bicuspid Aortic Valve

Bicuspid Aortic Valve (BAV) is the most common congenital heart defect, occurring in about 1-2% of the population. Unlike the normal tricuspid aortic valve, which has three leaflets, a bicuspid aortic valve has only two. This condition develops in the womb and is more common in males, with a male-to-female ratio of about 3:1. While many individuals with BAV may not experience symptoms, the condition can lead to serious complications over time if left untreated.

Complications and Risks

Bicuspid Aortic Valve is prone to early degeneration, which can lead to two major complications:

• Aortic Stenosis: This occurs when the valve becomes narrowed, restricting blood flow from the heart to the body. Over time, this can lead to symptoms such as breathlessness, chest pain, dizziness, and even heart failure.
• Aortic Regurgitation: In some cases, the valve does not close properly, causing blood to leak back into the left ventricle. This backflow can increase the workload on the heart and eventually lead to heart failure if not managed properly.

Additionally, individuals with BAV are at risk of developing an aortic aneurysm, a condition where the aorta—the main artery leading from the heart—becomes dilated. If the aneurysm becomes large enough, it can rupture, leading to life-threatening complications.

Symptoms and Diagnosis

Many people with Bicuspid Aortic Valve are asymptomatic and may only discover the condition incidentally during a cardiac ultrasound (echocardiogram) performed for other reasons. When symptoms do appear, they can include:

• Breathlessness
• Chest pain
• Dizziness or lightheadedness
• Fatigue
• Ankle swelling

Diagnosis typically involves an echocardiogram, and in some cases, additional tests such as a cardiac MRI may be recommended to assess the condition of the aorta and valve more comprehensively.

Treatment and Management

The management of Bicuspid Aortic Valve depends on the severity of the condition and any complications that arise. Regular monitoring through echocardiography is crucial for those diagnosed with BAV to track the progression of the disease.

Surveillance: Most individuals with BAV are kept under regular surveillance. If the valve becomes significantly narrowed or leaky, the frequency of monitoring will increase.

Surgical Intervention: If the valve degeneration leads to severe aortic stenosis or regurgitation, surgical options such as valve repair or replacement may be necessary. In cases where an aortic aneurysm is detected and reaches a critical size, surgery may be required to replace the affected section of the aorta to prevent rupture.

Lifestyle Considerations

Living with Bicuspid Aortic Valve involves adhering to a heart-healthy lifestyle. This includes regular, gentle exercise, maintaining a balanced diet, avoiding smoking, and taking special care to prevent infections that could lead to endocarditis. Good dental hygiene and careful skin care are essential in reducing the risk of infections that could affect the heart valve.