Types of Aortic Valve Disease

At NYU Langone, cardiologists, cardiothoracic surgeons, and interventional cardiologists treat both aortic valve stenosis and aortic valve regurgitation.

The heart is divided into four chambers. The two upper chambers, called the atria, receive blood after it has circulated through the body or lungs. The two lower chambers, which are called ventricles, pump blood to other parts of your body. Valves are located in each chamber; they ensure that blood flows into your arteries without backing up.

The aortic valve is the gateway between the left ventricle, which is the largest chamber of the heart, and the aorta, the body’s largest artery. The aortic valve has three flaps, called leaflets, that open to allow blood to enter the aorta and close to prevent blood from flowing backwards into the heart.

Aortic Valve Stenosis

In aortic valve stenosis, a narrowing of the aortic valve prevents it from opening properly. This forces the heart to work harder to pump blood, causing pressure to build in the left ventricle, sometimes weakening the heart muscle.

Aortic valve stenosis is the most common heart valve disorder in people over age 75, and it occurs more frequently in men. It’s typically caused by a buildup of calcium in the aortic valve, which occurs with aging.

Other causes include a congenital condition known as bicuspid aortic valve, in which a person is born with two aortic valve leaflets, instead of three. This can lead to aortic valve stenosis at a younger age than typically seen in people with this condition. A small number of people have scarring of the aortic valve due to rheumatic fever in childhood that can also cause the valve to narrow.

Aortic Valve Regurgitation

Aortic valve regurgitation, also called aortic valve insufficiency, occurs when the aortic valve doesn’t close properly, causing blood to flow back into the heart. This requires the heart to work harder. Over time, the condition causes the heart to stretch and enlarge and can lead to heart failure. Your chance of developing this condition increases with age.

There are two subtypes of aortic valve regurgitation.

Chronic Aortic Valve Regurgitation

In the chronic form of aortic valve regurgitation, symptoms tend to build slowly over time. This may be caused by aging, being born with an abnormal aortic valve, childhood rheumatic fever, enlargement of the aorta resulting from high blood pressure, or atherosclerosis, a hardening of the arteries.

Acute Aortic Valve Regurgitation

Acute aortic valve regurgitation occurs suddenly, leading to shortness of breath and sometimes heart failure. It can be caused by an aortic dissection, which is a tear in the aortic wall; endocarditis, an infection of the heart; or trauma to the heart or aorta, such as from a car accident.