Does your heart have two cusps in the aortic valve? (Bicuspid Aortic Valve) Let's talk about this!

Do you sometimes feel tired or exhausted? Or have you ever had a doctor put a stethoscope to your chest and say something like, "Mmm... I hear a little strange sound (murmur) coming from your heart"? The cause of this could be a small change in your heart that you were born with. Don't worry, today we're talking about a common condition called Bicuspid Aortic Valve.

Simply put, what is this Bicuspid Aortic Valve?

Okay, let's understand this this way. There are four main valves in our heart. These are like gates that open only in one direction. Of these, the one that sends blood to the aorta, the main blood vessel that carries oxygen-rich blood from the heart to the entire body, is called the aortic valve. Normally, in a healthy person, this aortic valve has three small flaps (cusps or leaflets). These three flaps open and close in a very orderly manner to control the flow of blood. However, in a person with a condition called the bicuspid aortic valve, this valve has two flaps instead of three . This is a congenital condition. So, since there are only two flaps, this valve can have a little difficulty opening and closing properly. This can lead to two main problems: 1. Aortic Stenosis (narrowing of the valve): Because the valve does not open properly, there is only a small amount of space for the heart to pump blood to the body. This makes the heart work harder. 2. Aortic Regurgitation (backflow of blood): Because the valve does not close properly, some of the blood pumped to the body leaks back into the heart. You may not have any symptoms for years. But over time, this extra strain can cause problems for your heart.

How serious is this situation?

Not everyone with Bicuspid Aortic Valve will have major problems. But about one in three people will develop complications over time. That's why it's important to have regular check-ups and check-ups if your doctor tells you you have this condition. It's not as rare as you might think. It affects 1% to 2% of the world's population. It's also twice as common in men as it is in women. People with certain genetic conditions, such as Turner syndrome, are also at higher risk. The best part is that with today's advanced medical technology, you can detect this condition and its subtle changes before you even notice symptoms. And with proper treatment, you can live a full, healthy, and long life.

What are the symptoms of this?

Many people do not have any symptoms for years. However, as the valve function deteriorates, symptoms begin to appear. In young children and infants, if the condition is severe, symptoms such as a bluish/pale color of the skin (` cyanosis` ) and difficulty eating or gaining weight may appear shortly after birth. The most common symptoms seen in adults are:

What causes this? Is it hereditary?

The exact cause of this `Aortic valve` has not yet been found. This is something that happens when the heart of the fetus develops in the early stages of pregnancy. This condition can run in families to some extent (hereditary) . That is, if someone in your immediate family (mother, father, sibling, child) has this condition, you may also have some risk. Therefore, if anyone in your family has this type of heart valve disease, it is very important to tell your doctor about it. Then, if he or she wants, you can also be tested.

What complications can occur if left untreated?

If not treated on time, serious complications can occur.

• Heart failure: Narrowing of the valve (stenosis) causes the heart to work harder. This can cause the heart muscle to thicken and enlarge, eventually making it unable to pump blood efficiently. Things like smoking and high cholesterol can speed up this process.
• Aortic aneurysm rupture and dissection: About one in three people with a bicuspid aortic valve are at risk of the aorta, the large artery above the valve, becoming dilated. Like a balloon being overinflated, the walls of this blood vessel weaken and begin to bulge. This is called an aortic aneurysm. If it gets too big, it can suddenly burst (rupture) or tear (dissection). This is a life-threatening emergency that requires immediate treatment .

How is this disease diagnosed?

Often, a doctor will first suspect a heart murmur when they hear an unusual sound (a `heart murmur`) while listening to your chest with a stethoscope. After that, your doctor will order several special tests to look at the structure and function of your heart. The main tests are:

• Echocardiogram (echo): This is an ultrasound scan of the heart. It can clearly see the number of leaflets in the valve, how they work, and whether there is any leakage or narrowing.
• CT scan (Computed Tomography scan): This can produce three-dimensional images of the heart and aorta.
• Heart MRI (Magnetic Resonance Imaging): This test is used to obtain more detailed images of the heart and valves.

What are the treatment options?

While some medications, such as beta-blockers, can help control symptoms, they cannot completely cure the valve problem. About 4 out of 5 people with Bicuspid Aortic Valve will need surgery at some point in their lives. Surgery can either repair your valve or replace it with a new one. Your medical team will discuss with you the best treatment for you, based on your condition, age, and overall health.

Types of surgery

Nowadays, instead of traditional open-heart surgery, there are modern methods such as minimally invasive surgery and TAVR (Transcatheter Aortic Valve Replacement), which replaces the valve through a blood vessel. These methods have shorter recovery times.

How is recovery and the future?

98% of people who undergo valve surgery recover successfully, and their life expectancy is not affected. This means that even if you have a Bicuspid Aortic Valve condition, with proper treatment and medical supervision , you can live a long, healthy life like anyone else. The most important thing is to go to your regular follow-up appointments with your doctor. After surgery, you usually need to go for a check-up at least once a year.

When do you need to be hospitalized urgently? (When to go to the ETU)

The symptoms of an aneurysm rupture are very dangerous. If you experience one or more of these symptoms, call 911 immediately for an ambulance or go to the nearest hospital Emergency Department (ETU).

• A sudden, sharp, tearing pain in the chest or back.
• Sticky, sweaty skin.
• Dizziness.
• Fainting.
• Heart palpitations.
• Nausea and vomiting.
• Severe difficulty breathing.

Bicuspid Aortic Valve, Heart Valve Disease, Aortic Stenosis, Aortic Regurgitation, Heart Surgery, Chest Pain, Shortness of Breath