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Understanding Aortic Valve Disease

Featuring: Interventional Cardiologist Richard Kovach, MD

Over a 70-year lifetime, your heart beats at least 2.5 billion times. THAT’S B for BILLION!

How many times do you flex a hip or knee joint over that same amount of time? Not even close to that number, yet many require replacement during that span.

The working parts of the amazing human heart also experience wear and tear, and often, the valve between the heart’s main pumping chamber and the body’s main artery starts to malfunction later in life.

The aorta starts in the lower-left part of the heart and passes through the chest and abdomen, then branches off to organs and supporting tissue to deliver oxygen-rich blood to your body. The hard-working aortic valve maintains a one-way outflow on each beat… unless it becomes diseased or damaged, most often as a function of aging.

The typical aortic valve is comprised of three flaps called leaflets, which can get caked with calcium in a stiffening process called aortic stenosis.

“With each beat the leaflets normally open and close again,“ explains Interventional Cardiologist Richard Kovach, MD. “But with aortic stenosis, the stiff valve does not open completely. That creates significant obstruction to blood flow, and puts a big strain on the heart muscle to overcome that stiff valve.”

Another form of aortic valve disease is aortic insufficiency or regurgitation.

“That’s where the valve doesn’t close properly,” Dr. Kovach continues. “So instead of that valve forming a nice tight seal when it closes, blood leaks back into the ventricle. So, some of the blood is going forward, some of the blood is coming backwards. That makes the heart also have to work harder to pump enough blood for the body to make up for the blood that’s leaking back into the main chamber; it has to work doubly hard to pump enough blood out to the body to maintain enough blood pressure to provide for the needs of the body.”

Aortic valve disease can range from mild to severe, as can symptoms:

  • Irregular heart sound (heart murmur)
  • Chest pain during activity
  • Fainting or dizziness with exertion
  • Shortness of breath, especially during physical activity
  • Fatigue, particularly during increased activity
  • Rapid, fluttering heartbeat (palpitations)

Diagnosis requires thorough examination, testing, and imaging. Treatments depend upon the severity of disease and can involve replacing the faulty valve.

In this episode, KYW’s Rasa Kaye discusses aortic valve disease with Dr. Kovach, including Deborah’s team approach to identifying, managing and treating the condition, and the latest advances in Transcatheter Aortic Valve Replacement (TAVR).

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