Aortic Valve Disease

There are three common things that could be wrong with your aortic valve. You could have stenosis (when the opening to your valve gets narrow or stiff), regurgitation (when your valve doesn’t close completely and leaks), or you could have a bicuspid aortic valve (when your valve has only two leaflets or flaps instead of three).

Sometimes the symptoms of these conditions aren’t noticeable. When you do feel something, you might be very tired, have swollen ankles or feel like your heart is skipping a beat. You might not feel any symptoms at all. If the disease is farther along, you might have chest pain, shortness of breath or feel dizzy.

At your appointment, your healthcare provider will ask about your medical history and if anyone in your family has heart problems. They’ll also want to know what symptoms you might be experiencing. Your provider may also listen to your heart through a stethoscope. If they hear a murmur (unusual whooshing sounds), that might mean there’s a blood flow problem in one of your heart’s valves. Not all murmurs are something to worry about, but it’s important to find out what’s causing the murmur and to check on it over time.

If you have a heart murmur and/or any of the symptoms mentioned above, your provider may order one or more of these tests to confirm a diagnosis:

• Echocardiogram (Echo): This test uses high-frequency sound waves (ultrasound) from a handheld wand on your chest to take pictures of your heart’s valves and chambers and see how well your heart’s pumping.
• Electrocardiogram (EKG): Your provider will put sticky electrode pads on your chest, arms and legs to measure your heart’s electrical activity.
• Computed tomography (CT scan): This test takes three-dimensional pictures of your heart to show how blood is flowing through your heart and vessels.
• Magnetic resonance imaging (MRI): An MRI uses powerful magnets and radio waves to take moving pictures of your heart while it’s pumping to see if there’s unusual blood flow through your heart.
• Cardiac catheterization (cardiac cath or angiogram): Your provider will put a small, flexible tube (catheter) into your leg or arm and pass it through a blood vessel to the inside of your heart to see how it’s working.
• Chest X-ray: A chest X-ray uses a focused beam of radiation to look at your heart.
• Exercise stress test: Your provider will have you walk on a treadmill or pedal a stationary bike while you’re hooked up to an EKG machine to check your heart’s activity when it’s working hard.

Your treatment will depend on the type of aortic valve disease you have, how bad it is, your age, medical history and family medical history. It’ll also depend on your goals — what you want to achieve with treatment. If you don’t have any symptoms or your symptoms are mild, your provider may simply keep an eye on your condition with regular checkups and repeated testing. If your condition is more serious, treatment options may include:

• Medication: Since heart valve disease is a mechanical or “plumbing” problem (think of the valves in your house that control the water supply not working right), medicines aren’t a cure. Eventually, the faulty valve will need to be repaired or replaced. Some medicines, though — such as diuretics (water pills), beta-blockers or anticoagulants (blood thinners) — can relieve mild symptoms, help your heart pump better and lessen the chance of further valve damage.
• Transcatheter aortic valve replacement (TAVR): TAVR is a minimally invasive procedure that replaces your aortic valve using a small tube (catheter) that’s put into an artery in your groin or neck instead of making a large incision (cut) in your chest. Your provider will let you know if TAVR is an option for you.
• Surgery: If your valve is severely damaged, it might be necessary to fix it with surgery. Your provider will decide if your valve can be repaired without using artificial parts, or if it needs to be replaced with a biological valve (from a cow or pig) or a mechanical valve (made from carbon and metal).

Traveling for Heart Care at Cleveland Clinic

We know that traveling for any kind of healthcare can be stressful and intimidating. If you’re coming to us from another city, state or even another country, we’re here to help make things as easy and convenient as possible for you. From knowing where to stay and where to eat, how to get to and from the airport, shop, or just find your way around any of our hospitals, we’re here for you.

If you’re an international patient, our experienced and compassionate Global Patient Services (GPS) team will help you navigate the Cleveland Clinic health system. They’ll connect you with the healthcare providers you need, help make appointments, provide language translation services and coordinate follow-up care when you return home.

Taking the Next Step

Hearing the words heart valve disease can be a shock. And after the shock goes away, you’re often left with, “what now?” The most important thing to remember is that you’re not alone. Cleveland Clinic’s expert heart team is the best in the nation. We’re a team you can trust and build a relationship with. We’ll help you get past the shock and help you face the “what now” part of your healthcare journey with confidence.