Aortic Valve Disease: Symptoms, Diagnosis & Treatment in Lucknow

The aortic valve plays an important role in maintaining healthy blood circulation. It controls blood flow from the heart’s left ventricle into the aorta, which carries oxygen-rich blood to the rest of the body. When this valve becomes narrowed or fails to close properly, it can affect how efficiently the heart pumps blood.

Aortic valve disease in Lucknow is a condition that requires timely medical evaluation, especially when symptoms such as breathlessness, chest discomfort, dizziness or unusual fatigue develop. Early diagnosis helps doctors understand the severity of the condition and recommend suitable treatment.

Dr. Ankit Thukral, Cardio Thoracic & Vascular Surgeon and Senior Consultant and Vice Chairperson CTVS at Chandan Heart Institute, Lucknow, provides surgical expertise in the management of various heart and vascular conditions.

What Is Aortic Valve Disease?

Aortic valve disease refers to conditions that affect the structure or function of the aortic valve. A healthy aortic valve opens when the heart pumps blood and closes to prevent blood from flowing backward.

When the valve does not open or close properly, the heart has to work harder to maintain blood circulation. Over time, this extra workload may affect heart function.

The two major types of aortic valve disease are:

1. Aortic Stenosis

Aortic stenosis occurs when the aortic valve becomes narrowed. This restricts blood flow from the heart into the aorta.

Common causes include:

• Age-related calcium deposits on the valve.
• Congenital abnormalities, such as a bicuspid aortic valve.
• Previous rheumatic heart disease in some patients.

As the narrowing becomes more severe, the heart must pump with greater force to move blood through the valve.

2. Aortic Regurgitation

Aortic regurgitation occurs when the aortic valve does not close completely. As a result, some blood flows backward into the left ventricle after each heartbeat.

This backward flow increases the heart’s workload. Over time, it may cause enlargement of the left ventricle and reduced pumping efficiency.

Possible causes include:

• Aortic valve abnormalities.
• Enlargement of the aortic root.
• Previous infections affecting the heart valve.
• Certain connective tissue disorders.
• Damage related to other heart conditions.

Common Symptoms of Aortic Valve Disease

Some people with aortic valve disease do not experience symptoms during the early stages. However, symptoms may develop as the condition progresses.

Watch for the following warning signs:

1. Breathlessness

Shortness of breath during physical activity can occur when the heart struggles to maintain adequate blood circulation. In advanced cases, breathing difficulty may also occur while resting or lying down.

2. Chest Pain or Discomfort

Chest pressure, tightness or pain may develop, particularly during physical activity. This symptom requires medical evaluation because it can also indicate other serious heart conditions.

3. Dizziness or Fainting

A narrowed aortic valve can limit the amount of blood reaching the body during activity. Some patients may experience dizziness, light-headedness or fainting.

4. Unusual Fatigue

When the heart cannot pump blood efficiently, everyday activities may become tiring. Persistent weakness or reduced exercise tolerance should not be ignored.

5. Palpitations

Some patients experience an awareness of their heartbeat, including a racing, fluttering or irregular sensation. Palpitations can have several causes and need appropriate assessment.

What Causes Aortic Valve Disease?

Several factors can contribute to aortic valve problems. The cause may differ from one patient to another.

Common risk factors and causes include:

• Age-related changes: Calcium can accumulate on the aortic valve over time, making it stiff.
• Congenital valve conditions: Some people are born with a bicuspid aortic valve instead of the usual three leaflets.
• Rheumatic heart disease: Previous rheumatic fever can damage heart valves.
• Infective endocarditis: Infection involving the inner lining of the heart can damage the valve.
• Aortic root enlargement: Changes in the aorta near the valve may prevent it from closing properly.
• Other medical conditions: Certain connective tissue disorders can affect the aortic valve and nearby structures.

Identifying the underlying cause helps doctors plan appropriate monitoring and treatment.

How Is Aortic Valve Disease Diagnosed?

Accurate diagnosis helps determine the type and severity of valve disease. A doctor may recommend several tests depending on the patient’s symptoms and medical history.

1. Clinical Examination

The doctor reviews symptoms, medical history and risk factors. A stethoscope examination may identify a heart murmur, which can suggest abnormal blood flow through the valve.

2. Echocardiography

Echocardiography is one of the most important tests for evaluating aortic valve disease. It uses ultrasound waves to produce images of the heart.

It helps doctors assess:

• Aortic valve structure and movement.
• Severity of valve narrowing or leakage.
• Blood flow across the valve.
• Heart chamber size and pumping function.

3. Electrocardiogram (ECG)

An ECG records the electrical activity of the heart. It can help identify abnormal heart rhythms and certain changes associated with increased heart workload.

4. CT Scan or Cardiac Imaging

A CT scan may help assess calcium deposits, the aortic root and other anatomical details. Doctors may recommend additional imaging when planning surgery or evaluating associated conditions.

5. Cardiac Catheterisation

In selected cases, cardiac catheterisation helps measure pressures inside the heart and assess coronary arteries. Doctors may recommend it when the results are necessary for treatment planning.

Treatment Options for Aortic Valve Disease in Lucknow

Treatment depends on the type of valve problem, its severity, symptoms, heart function, age and overall health.

Some patients only need regular monitoring, while others may require medication to manage associated symptoms or surgery to correct the valve problem.

1. Regular Monitoring

Patients with mild or moderate disease and no significant symptoms may not need immediate surgery.

Doctors may recommend periodic check-ups and echocardiograms to monitor valve function and detect changes over time.

2. Medication

Medicines may help manage conditions such as high blood pressure, fluid retention or abnormal heart rhythms.

However, medicines generally cannot correct severe mechanical narrowing or leakage of the aortic valve. The need for valve intervention depends on clinical findings.

3. Aortic Valve Repair

In selected patients, surgeons may repair the existing valve rather than replace it. The suitability of repair depends on the valve’s structure, the cause of the disease and the extent of damage.

4. Aortic Valve Replacement Surgery

When the valve becomes severely narrowed or damaged, replacement may be recommended.

During the procedure, the surgeon removes the diseased valve and replaces it with an artificial valve.

The two main types are:

Mechanical Valve: This valve is made from durable materials and can last for many years. Patients with mechanical valves usually require lifelong blood-thinning medication and regular monitoring.

Biological Valve: This valve is made from animal or human tissue. It may not require lifelong anticoagulation solely because of the valve, but its durability can be limited and depends on several patient-related factors.

The surgeon discusses the benefits, risks and long-term considerations of each option before recommending a suitable valve.

5. Transcatheter Aortic Valve Replacement (TAVR/TAVI)

TAVR or TAVI is a minimally invasive procedure in which a replacement valve is delivered through a catheter, commonly through an artery in the groin.

It may be suitable for selected patients depending on their anatomy, age, surgical risk and overall medical condi