Aortic Valve Disease

Aortic valve disease occurs when the aortic valve is narrowed or does not close properly, limiting or reversing blood flow between the heart and the aorta. Aortic stenosis means the valve cannot open fully, while aortic regurgitation means blood leaks backward because the valve does not seal completely. The condition may be mild, moderate, or severe and can affect people because of congenital valve differences, aging, or other heart and health problems.

Symptoms depend on the type and severity of the valve problem, and early disease may cause no noticeable symptoms. As narrowing or leakage becomes more significant, the heart may need to work harder to move blood through the body.

Aortic stenosis develops when the valve leaflets become thickened, stiff, fused, or covered with calcium deposits, making the opening smaller. Aortic regurgitation occurs when the leaflets do not seal completely, allowing blood to leak back into the left ventricle. These changes can result from aging, congenital differences, infection, rheumatic disease, or problems affecting the aorta.

Having a risk factor does not mean that someone will develop aortic valve disease. Controlling cardiovascular risks can support overall heart health and may reduce harmful strain, even when the valve abnormality itself cannot be prevented.

Diagnosis begins with a medical history and physical examination. A clinician may listen for an aortic stenosis murmur or another abnormal heart sound and check for signs of heart failure, such as swelling or breathing difficulty.

Echocardiography

An echocardiogram is the main test for aortic valve stenosis and other valve problems. It shows how the valve moves, the speed of blood flow, the amount of leakage, the size of the heart chambers, and how well the heart pumps.

Additional tests may include an electrocardiogram, chest X-ray, cardiac CT or MRI, and cardiac catheterization. Clinicians use these tests when they need more information about severity, the effect on the heart, or planning for a procedure.

Monitoring and medicines

Mild or stable aortic valve disease may be monitored with regular visits and repeat echocardiograms. Medicines may help control blood pressure, fluid buildup, rhythm problems, or the risk of blood clots, but they usually cannot remove a severely narrowed valve. This approach may suit people without significant symptoms or those whose disease is stable; ongoing care includes tracking symptoms and adjusting treatment when needed.

Surgical valve repair or replacement

Open-heart surgery may repair the valve or replace it with a mechanical valve or a tissue valve. It is considered for people with severe disease, symptoms, reduced heart function, or other findings that make intervention appropriate. Recovery generally includes a hospital stay followed by gradual activity increases and cardiac rehabilitation, with long-term follow-up.

Transcatheter valve procedures

During transcatheter aortic valve replacement (TAVR), a replacement valve is delivered through a catheter, often from a blood vessel in the leg, and placed inside the diseased valve. It may be considered for selected people with severe aortic stenosis based on age, health, anatomy, surgical risk, and shared decision-making. Recovery is often shorter than after open surgery, but follow-up visits and heart imaging are still needed.

Not all aortic valve disease is preventable, especially congenital valve differences and age-related calcium buildup. However, reducing cardiovascular risks and treating infections promptly can support heart health and may help limit avoidable strain on the valve and heart.

Mild aortic valve disease may remain stable for years with regular monitoring, while severe symptomatic disease can strain the heart and worsen without treatment. The outlook depends on the type of valve problem, its severity, symptoms, heart function, and access to timely care. Valve repair or replacement can improve symptoms and heart function for many people, but lifelong follow-up may still be needed.