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

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.

Answer 2

A transesophageal echo is best to asses right an left atriums, but not so much left ventricle. The problem with bicuspid valves is exactly as you stated, the greater tendency to become stenotic, because by itself, a bicuspid failed to disjoint itself, so it tends to stenosis. An echo after a meal would be affected only if you were eating just as they were taking it, or if you have some GI problems. Remember that pressures have to change by exercise and movement to compensate, so it is normal to have variants in pressure. Just make sure your visits are every six to 12 months, and just keep off the fat, which by living in Japan, you most probably are! Take care, and keep on livinginstead of worrying about it

Answer 3

Why did you ask this question twice?