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Heart Valve Stenosis & Regurgitation

Overview

The aortic valve opens and closes to allow blood to flow out of the heart to the rest of the body. Heart valve stenosis, or aortic stenosis, occurs when the aortic valve becomes blocked and cannot fully open. The narrowed valve has to work harder to pump blood throughout the body, which can lead to unpleasant symptoms. Aortic regurgitation occurs when the aortic valve does not close completely after each heartbeat, which results in blood leakage. Both heart problems can occur alone or simultaneously, and symptoms range from mild to more severe. Heart valve stenosis and regurgitation can be congenital heart defects that are present at birth, or they can develop over time.

  • Symptoms

    Aortic valve stenosis and aortic regurgitation share similar symptoms, including:

    • Chest pain
    • Fainting or dizziness
    • Fatigue
    • Heart palpitations
    • Shortness of breath, whether during activity or at rest
    • Weakness with activity

    Adults with aortic stenosis may also experience a bloody cough and tight chest pains that worsen with activity. Those with aortic regurgitation could have additional symptoms, including a strong, throbbing heartbeat, a rapid pulse and swelling in the legs, feet and abdomen.

  • Prevention

    Some cases of stenosis and regurgitation are congenital, meaning they exist at birth and cannot be prevented. For other cases, the following steps could keep you from developing either heart problem:

    • Make heart health a priority. This includes daily exercise, controlling high blood pressure and cholesterol, and quitting smoking.
    • Treat infections properly. Untreated gum infections and rheumatic fever could lead to stenosis or regurgitation later in life. Taking antibiotics for onset of rheumatic fever or gum disease could prevent developing either heart condition.
  • Risk Factors

    • Heart valve stenosis and regurgitation can be present at birth, or they can develop over time.
    • History of rheumatic fever
    • Older age, which leads to wear and tear of the valves
  • Diagnosis

    Aortic Valve Stenosis

    • Clinical examination. Your healthcare provider may use a stethoscope to check for a heart murmur and any abnormal sounds. The provider may also check for a faint pulse and low blood pressure.
    • Transthoracic echocardiogram (TTE). This is the most common test to detect aortic stenosis. An instrument is placed on parts of the chest and upper abdomen to pick up sound waves. These sound waves are translated into images of the heart valve and other structures. Your provider can see any abnormalities with the heart.
    • Other heart tests. Your physician may order other tests to help with diagnosis, including an electrocardiogram, exercise stress testing, a heart MRI or transesophageal echocardiogram (TEE).

    Aortic Valve Regurgitation

    • Clinical examination. Your healthcare provider may check for signs of regurgitation, such as forceful heart beating, a strong pulse in arms and legs and low diastolic blood pressure.
    • Imaging tests. A physician may order special imaging tests to help detect regurgitation, including an aortic angiography, echocardiogram, heart MRI and chest X-ray.
    • Left heart catheterization. This test uses a thin tube called a catheter to reach the left side of the heart. The procedure measures pressure and function of the heart, which helps with diagnosis for regurgitation.
  • Treatment

    • Lifestyle changes. Your physician may recommend you make certain lifestyle changes, such as quitting smoking, following a healthy diet and staying at a healthy weight, to manage symptoms of stenosis or regurgitation.
    • Valve repair. If the heart valve becomes extremely blocked or leaky, it may need to be repaired. This can be done through interventional catheterization, which is a minimally invasive procedure that uses a balloon to force the valve open. Open-heart surgery is also an option for valve repair.
    • Valve replacement. The only way to replace a valve is with open-heart surgery. Your physician will help you choose the type of replacement if this is the best option for you.
  • Follow-up Care

    Your physician may recommend you do the following for care after a surgical procedure:

    • Routine examinations that monitor progression
    • Limit vigorous activity
    • Take medications to keep blood pressure low