Clinical findings in bicuspid aortic valve
Although it is often asymptomatic in childhood, it may cause complications such as aortic valve dysfunction, aortic dissection and infective endocarditis in adulthood. Depending on the degree of stenosis and insufficiency in the valve, we may encounter chest pain, shortness of breath, fatigue, fainting, weakness, dizziness, palpitations that become evident with exertion, sometimes rhythm disturbance or, very rarely, sudden death in advanced cases. Most of the time, it may not cause any symptoms in the clinic until the age of 30, or sometimes it can only be detected when an echo is performed due to a heart murmur. Early diagnosis of bicuspid aortic valve is extremely important in terms of preventing complications and early treatment. For this reason, echocardiography screening is recommended for family members of patients diagnosed with bicuspid aortic valve.
Monitoring and treatment in bicuspid aortic valve
Monitoring and treatment are planned according to the severity of stenosis and insufficiency in the valve. In terms of infective endocarditis, antibiotic prophylaxis must be given before interventional procedures (such as tooth extraction, filling or root canal treatment, circumcision, surgical operations, endoscopy, adenoid or tonsil surgeries). Monitoring is done by echocardiography, and clinical follow-up will be appropriate at 6-month or 1-year intervals, depending on the condition of the valve. In some cases, especially in cases with enlargement of the ascending aorta and aortic root, cardiac CT angiography and cardiac MRI may be required. Almost every case should be evaluated on a patient-by-patient basis, and it should be determined whether the patient can participate in sports activities or become a professional athlete, and the family should be informed in detail about this. In necessary and appropriate cases, catheter angiography and balloon valvuloplasty can be performed to expand the valve with a balloon. In some cases, oral medication may be given. Sometimes open heart surgery and natural or mechanical valve replacement surgery may be considered.
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