Why choose UW Medicine?

Treatment for bicuspid aortic valve requires precision and expertise. Whether doctors monitor your condition or you need bicuspid aortic valve surgery, the expert heart surgeons and cardiologists at the UW Medicine Heart Institute use the latest diagnostic and surgical technologies to deliver the care you need. Our dedicated care teams are here to support you every step of the way. We’ll help you understand what to expect and how to manage your health in the future so you can live the life you want. As one of the most trusted heart programs in the Pacific Northwest, you can rest easy knowing you are in good hands.

What is a bicuspid aortic valve?

Bicuspid aortic valve is an abnormality in the heart’s aortic valve. Valves help blood flow through the heart’s chambers. The aortic valve connects the aorta, the main artery leading to the body and the left ventricle, which pumps oxygenated blood. 

What causes a bicuspid aortic valve?

Bicuspid aortic valve is  present from birth (congenital) and tends to run in families. It’s one of the most common congenital heart defects and is more common in boys than in girls. It can also be due to a genetic abnormality such as Marfan’s syndrome. 

For people who have congenital bicuspid aortic valve, the following factors can make the condition worse: 

  • High cholesterol levels
  • High blood pressure
  • Smoking
  • Chronic kidney disease

What are the symptoms of a bicuspid aortic valve?

Some people born with a bicuspid aortic valve might have symptoms early in life. In other cases, the aortic valve works well for many years and doesn’t cause symptoms until adulthood. Many adults may not realize they have a bicuspid aortic valve until a doctor diagnoses it. Most commonly, however, people start to have symptoms during middle age.

Common bicuspid aortic valve symptoms include:

  • Shortness of breath with exercise
  • Chest pain
  • Lightheadedness or fainting with exercise
  • Unable to exercise or loss of stamina
  • Fatigue (tiredness) 

What are the complications of a bicuspid aortic valve?

Bicuspid aortic valve can lead to several complications if left untreated. These include the following:

In this condition, the aortic valve won’t open as easily as it should when the heart squeezes. This means the left side of the heart has to work harder to move blood to the body. Over time, this can damage the heart muscle and lead to heart failure.

This condition occurs when the bicuspid aortic valve “leaks.” It causes blood to flow back into the heart when it relaxes instead of flowing forward into the body. This condition also makes the heart work harder.

This condition is an infection of the heart valves. Your doctor may give you special instructions about how to help prevent it.

This condition causes abnormal heart rhythms 

No known treatment can prevent bicuspid aortic valves from developing stenosis or regurgitation. Medicines for high blood pressure or high cholesterol may help some people.

Sometimes, bicuspid aortic valve first appears on an echocardiogram done for other reasons.

How is bicuspid aortic valve diagnosed?

Your doctor will ask about your symptoms and health history. You will also need a physical exam. 

Some tests can also help with the diagnosis. These include:

This test shows the movement of blood through the valve using ultrasound and is most often used to diagnose bicuspid aortic valves.

This ultrasound of the heart is taken from the esophagus (throat), which can produce better pictures of the aortic valve.

This test uses electrodes placed on the chest to check the heart’s electrical rhythm.

These images help view the structure of the heart and lungs.

These imaging tests can provide more detail about the valve, heart or aorta.

Sometimes, bicuspid aortic valve first appears on an echocardiogram done for other reasons.