The aortic valve sits between the pumping chamber (the ventricle) and the aorta (main blood pipe out of the heart). This is very important to us as any defect will cause a significant decrease in blood going out of the heart. The valve can be affected in two ways
Stenosis is a narrowing of the valve causing a decrease in blood flowing out of the heart as a result the body is starving for good oxygenated blood. The heart has to pump harder to push blood against the resistance and over a period of time it becomes enlarged from increase in the muscle thickness quite similar to lifting weights in gym the more the resistance the greater the muscle bulk. The valve is narrowed by many causes such as
congenital aortic stenosis
Rheumatic aortic valve disease – stenosis or a combination of leak and stenosis
icuspid aortic valve
Calcific Aortic stenosis: Fibro-calcific degeneration most commonly affects the aortic valve. It most often occurs in adults over the age of 65. This condition can be compared to atheroma in coronary artery disease. The valve leaflets become fibrotic (thickened) and calcified (hardened), producing a narrowed valve opening. Risk factors for this type of valve disease include:
Also known as leaky valve. The blood flows to and fro freely across the valve which leads to enlargement of the heart due to the excess volume that it holds. . The causes of leaky valves are
Rheumatic heart disease- the leaflets are stiffened and pulled apart or the edges may get rolled up thereby resulting in non coaptation or lack of a meeting point of the leaflets.
Infective endocarditis: A severe bloodstream infection can seed the valve and damage it by causing a hole in the leaflets of by causing an infective vegetation to sit on the valve and prevent proper closure of the valve.
Syphilis; this infection is less common these days and causes disease of the aorta leading to dilatation or widening of the aortic annulus (ring that hold the leaflets) leading to a leak in the valve.
Marfans syndrome: It is a connective tissue disorder that cause weakening of the leaflets making them more floppy and in addition it can weaken the aortic annulus adding a component of annular dilatation. These lead to noncoaptation of the valve and significant leaks.
Degenerative: just as atherosclerosis can cause aortic stenosis it can also cause a combination of stenosis and leak by the same mechanism. Connective tissue disorders: the human body has a fair amount of elastic tissue when this tissue is present in excess it can cause floppy valves and lead to leaks.
Dilatation of the valve annulus is a widening or stretching of the annulus. This causes the leaflets to lack support and not close tightly. Dilatation may occur when the heart muscle is damaged due to: A heart attack (heart muscle injury)
