I have a question about bicuspid aortic valve?

Question

Firstly I'd like to say a big thank you to all the people who responded to my last question.Your answers were very helpful.Just to recap I'm a 43 year old Brit living in Japan married to a local lady with three young daughters.Last year I was diagnosed with bicuspid aortic valve by chance.My mean pressure gradient was 28mm and at another hospital 22mm. My valve area was 2.3cms.This year soon after having a very heavy meal the echo gave a reading of 37mm and 32mm.I'm going to another hospital to have a transoesophageal echo in June.I feel terrified that that my pressure gradient increased so much.The doctor said not to worry as I have no symptoms,stenosis or regurgitation but I'm afraid to say I still have sleepless nights.Last year the doctor said weight training,yoga and running was ok but now nothing is allowed.Would having an echo directly after eating a heavy meal cause this increase or is it due to my exercises.The doctor said Japan is quite medically advanced but I'm very down.

Answer 1

This article will help you out:

Complications

Aortic valve regurgitation — or any heart valve problem — puts you at risk of endocarditis. Endocarditis is an infection of the heart's inner lining — the endocardium. This membrane lines the four chambers and four valves of your heart. Typically, this infection involves one of the heart valves, especially if it's already damaged. If the aortic valve is leaky, it's more prone to infection than a healthy valve.

You can develop endocarditis when bacteria from another part of your body spread through your bloodstream and lodge in your heart. If you have aortic valve regurgitation, your doctor may recommend that you take antibiotics before certain dental or medical procedures to decrease the likelihood that bacteria will enter your bloodstream and cause an infection in your heart.

When it's mild, aortic valve regurgitation may never pose a serious threat to your health. But when it's severe, aortic valve regurgitation may lead to congestive heart failure. Congestive heart failure is a serious condition in which your heart is unable to pump sufficient blood to meet your body's needs.
Any way you are in safe hands.

Answer 2

Yes you would have always had this, it's something you were born with. A normal aortic valve is tricuspid, that is it has three closing flaps, but a bicuspid valve only has two flaps. Sometimes these bicuspid valves give no problems, but in some people they can lead to heart murmur later in life ( usually in your 30s or 40s ) because they allow a little blood to leak back the wrong way when they are closed. If this gets severe enough, you may need surgery to fit an artificial valve. This is pretty commonplace nowadays and not something to worry about.

Answer 3

You don't have to worry as long as the valve is patent. The haemodynamic effects of bicuspid valve only occur when you have a leak - stenosis where it is hard for the heart to force blood through the valve or regurgitation where the blood leaks back into the ventricle when the heart relaxes.

If you don't have either of those, your heart, valve and circulation will function just fine.

Oooh - there's a wiki page. Look even they say "The majority will cause no problems. However, especially in later life, a bicuspid aortic valve may become calcified, which may lead to varying degrees of severity of aortic stenosis and aortic regurgitation, which will manifest as murmurs. If these become severe enough, they may require heart surgery."

Have another ECHO check up at some stage. You will find the gradient goes up and down a little depending on your fluid status and blood pressure, how much salt you've been eating etc. Oh, and how much you're stressing - so RELAX! This is in fact important therapy for your heart.

Find some way to learn relaxation exercises - something like gentle yoga, meditation, self hypnosis ... etc I'd say tai chi but you're in Japan and I think Aikido would be a little much at present.

Japan is medically advanced. You're in good hands.