Presentation
Although bicuspid aortic valve disease is present at birth, it usually is not diagnosed until adulthood because the defective valve can function for years without causing symptoms. [my.clevelandclinic.org]
Rarely, patients can develop underlying arrhythmia which may present as palpitations or pre-syncopal episodes. [gponline.com]
Calcification and, in advanced cases, an enlargement of the heart, may be present in a chest X-ray. The physician may also perform cardiac catheterization. [heart-valve-surgery.com]
Stenosis - when the valve doesn't open enough and blocks blood flow Valve problems can be present at birth or caused by infections, heart attacks, or heart disease or damage. [icdlist.com]
Entire Body System
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Turkish
Turkish Journal of Medical Sciences. 1999;29(5):583-5. Available from: . Accessed in 2010 (Aug 30). [ Links ] 49. Fedak PW, David TE, Borger M, Verma S, Butany J, Weisel RD. [scielo.br]
Cardiovascular
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Heart Disease
Stenosis - when the valve doesn't open enough and blocks blood flow Valve problems can be present at birth or caused by infections, heart attacks, or heart disease or damage. [icdlist.com]
A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. Eur Heart J 2003;24(13):1231-43. Malhotra A. The changing burden of valvular heart disease. June 2012. [gponline.com]
ICD-10-CM Codes › I00-I99 Diseases of the circulatory system › I30-I52 Other forms of heart disease › I35- Nonrheumatic aortic valve disorders › Nonrheumatic aortic valve disorder, unspecified 2016 2017 2018 2019 Billable/Specific Code I35.9 is a billable [icd10data.com]
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Heart Murmur
The main sign of heart valve disease is an unusual heartbeat sound called a heart murmur. Your doctor can hear a heart murmur with a stethoscope. But many people have heart murmurs without having a problem. [icdlist.com]
Doctors usually base the diagnosis on a characteristic heart murmur heard through a stethoscope and on results of echocardiography. [msdmanuals.com]
Get your heart murmur checked People with heart murmurs are at an increased risk of an aortic valve disease called bicuspid aortic valve disease. [pennmedicine.org]
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Systolic Murmur
The harsh crescendo-decrescendo (or ejection systolic) murmur of AS is best heard in expiration in the aortic area, with the patient sitting forwards, and often radiates to the root of the neck. [gponline.com]
Does this patient have an abnormal systolic murmur?. JAMA. 1997 Feb 19. 277(7):564-71. [Medline]. Leach RM, McBrien DJ. Brachioradial delay: a new clinical indicator of the severity of aortic stenosis. Lancet. 1990 May 19. 335(8699):1199-201. [emedicine.medscape.com]
murmur of a harsh crescendo-decrescendo type, heard in 2nd right intercostal space, [19] radiating to the carotid arteries [18] Pulsus parvus et tardus, that is, diminished and delayed carotid pulse [18] [19] Fourth heart sound [18] Decreased A 2 sound [en.wikipedia.org]
murmur, is the auscultatory hallmark of mitral valve prolapse ( Table 1 ). [aafp.org]
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Water Hammer Pulse
[…] see also Endocarditis, aortic) hypertensive specified cause, except rheumatic specified cause NEC stenosis or obstruction valve (heart) (see also Endocarditis, aortic) valve or cusp (see also Endocarditis, aortic) valve (see also Endocarditis, aortic) Water-hammer [freemedicalcoding.com]
pulse (see also Insufficiency, aortic) 424.1 [icd9data.com]
hammer pulse [18] Austin Flint murmur [18] Apex beat displaced down and to the left [18] Third heart sound may be present [18] Holosystolic murmur at the apex, radiating to the back or clavicular area [18] Commonly atrial fibrillation [18] Third heart [en.wikipedia.org]
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Diastolic Murmur
A late diastolic murmur is occasionally present as a result of the regurgitant jet displacing the anterior mitral valve leaflet ( Austin Flint murmur ). [gponline.com]
PHYSICAL EXAMINATION An apical rumbling, diastolic murmur is characteristic and will immediately follow an opening snap, if present. [aafp.org]
Workup
Sometimes, a family doctor may hear a small heart murmur while listening to the heart, but since it is such a minor heart murmur and there are no symptoms or limitations, no workup or evaluation is necessary. [badaorta.com]
[…] anticoagulation, to treat associated post-stagnation thrombosis, or aortic valve replacement as the treatment, is debatable. 66 Sudden death may occur as a result of obstruction of the left ventricular outflow tract by a congenital BAV. 67 LABORATORY WORKUP [scielo.br]
Other Pathologies
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Myocardial Fibrosis
Exertional dyspnoea and other symptoms of heart failure worsen as the disease progresses, resulting in myocardial fibrosis and LV dysfunction. Patients may occasionally have an increased awareness of their heartbeat, often described as palpitations. [gponline.com]
In addition, global longitudinal strain alteration could reflect the presence of extensive myocardial fibrosis, also associated with worse prognosis [81]. [hindawi.com]
Hypertrophy
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Left Ventricular Hypertrophy
Diagnosis The electrocardiogram regularly reveals changes of left ventricular hypertrophy. Although sometimes significant calcification of the valve or ascending aortic dilation might be found, the chest radiograph is rarely helpful. [yorkcardiology.co.uk]
Severe aortic stenosis without left ventricular hypertrophy: prevalence, predictors, and short-term follow up after aortic valve replacement. Heart (1996); 76(3): 250-5. Jao G, Lystash J, Sane D. [gponline.com]
Left ventricular hypertrophy, its dilatation (cavity expansion), signs of ischemia (insufficient blood supply) can be identified during this examination. Chest X-ray. The heart has the form of a "boot". [bookinghealth.ae]
It is useful in symptomatic patients before surgery. [18] Chest X-ray showing left ventricular hypertrophy and dilated aorta [18] ECG indicating left ventricular hypertrophy [18] Echocardiogram showing dilated left aortic root and reversal of blood flow [en.wikipedia.org]
The ECG may show the strain pattern of lateral ST depression and T-wave inversion that marks left ventricular hypertrophy. As well, the P waves may show evidence of left atrial enlargement. [emedicine.medscape.com]
Treatment
Surgical Treatment of Aortic Valve Disorders If necessary, the aortic valve can be repaired or replaced with a synthetic or biological valve. [heart-valve-surgery.com]
Treatment varies on a case by case basis and often depends on the severity of the disease. [diseaseinfosearch.org]
Some valve problems are minor and do not need treatment. Others might require medicine, medical procedures, or surgery to repair or replace the valve. [icdlist.com]
Prognosis
Onset of symptoms indicates a worse prognosis and is associated with 15-50% mortality at 5 years. 8 The cardinal symptoms of severe AS are all typically provoked by exertion. [gponline.com]
Surgical replacement of the abnormal valve is the best treatment for nearly everyone, and the prognosis after valve replacement is excellent. [merckmanuals.com]
Prognosis of the four subsets as defined in Figure 1. The patients with low flow (stroke volume index 35 ml/m²) and low gradient ( 40 mmHg) incurred the worst prognosis. From reference [6]. [escardio.org]
Once symptoms develop, the prognosis becomes inferior and surgery is normally performed. Aortic stenosis is the most common cause for heart valve operation. [yorkcardiology.co.uk]
Surgical treatment has greatly improved the outlook (prognosis) in most people who have more severe stenosis. Surgery to widen or to replace the valve has a very good success rate. [patient.co.uk]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Mild aortic regurgitation has only been found in one neonate with BAV. 6 ETIOLOGY It has been noted that BAV is inheritable. [scielo.br]
The etiology of valvular disease influenced long-term rhythm recovery (p 0.01). [revportcardiol.org]
Aortic Valve Disease from Etiology to Bedside By Shahab Shahrzad and Samira Taban 1432 Open access peer-reviewed 4. [intechopen.com]
Epidemiology
Section 1: Epidemiology and aetiology Section 2: Making the diagnosis Section 3: Managing the condition Section 4: Prognosis Section 5: Evidence base Section 1: Epidemiology and aetiology Aetiology Anatomy In most people the aortic valve (AV) has three [gponline.com]
Hereditary ATTR amyloidosis Explore the pathophysiology, epidemiology and multi-system symptoms associated with hereditary ATTR amyloidosis, as well as how to achieve an early and accurate diagnosis. [epgonline.org]
Traumatology and Orthopaedics (195) Psychiatry, Psychology, Sexology (162) Gastroenterology and Hepatology (124) Microbiology (118) Haematology (115) Endocrinology, Metabolism (114) Pharmacology (106) Histology, Embryology (104) Obstetrics, Gynaecology (102) Epidemiology [portal.mefanet.cz]
[…] bernard.iung{at}bch.ap-hop-paris.fr Statistics from Altmetric.com The association of coronary artery disease with heart valve disease is frequently encountered and it can be expected that this association will become more common because of the evolution in the epidemiology [heart.bmj.com]
Epidemiology of acute rheumatic fever in New Zealand 1996-2005. J Paediatr Child Health. 2008 Oct. 44(10):564-71. [Medline]. Cunningham MW. T cell mimicry in inflammatory heart disease. Mol Immunol. 2004 Feb. 40(14-15):1121-7. [Medline]. [emedicine.medscape.com]
Pathophysiology
Ascending aortic dilatation associated with bicuspid aortic valve: pathophysiology, molecular biology, and clinical implications. Circulation 2009;119(6):880-90. Warnes CA. [gponline.com]
Hereditary ATTR amyloidosis Explore the pathophysiology, epidemiology and multi-system symptoms associated with hereditary ATTR amyloidosis, as well as how to achieve an early and accurate diagnosis. [epgonline.org]
An understanding of the pathophysiology of different valvar lesions and the haemodynamic changes they engender helps to guide the logical administration of drug treatment. [ncbi.nlm.nih.gov]
Physiology and Pathophysiology (554) Internal Medicine (507) Paediatrics, Neonatology (443) Medical Chemistry and Biochemistry (377) Pathology and Forensic Medicine (364) Neurology (265) Cardiology, Angiology (216) Infectology (201) Genetics (197) Surgery [portal.mefanet.cz]
This may be relevant from the pathophysiological point of view. [hindawi.com]
Prevention
The cause of this defect is not known, but there is no evidence that it can be prevented during pregnancy. [heart-valve-surgery.com]
Normally, the aortic valve has three small flaps or leaflets that open widely and close securely to regulate blood flow, allowing blood to flow from the heart to the aorta and preventing blood from flowing backwards into the heart. [my.clevelandclinic.org]
SBE can usually be prevented by taking an antibiotic before these procedures How is the problem diagnosed? Symptoms: Bicuspid aortic valve without aortic stenosis does not cause any symptoms. [chd-uk.co.uk]
Even in the absence of symptoms, aortic valve replacement may be necessary in some patients to prevent the irreversible damage to the heart muscle caused by the extra volume load. [circ.ahajournals.org]