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Leaky Aortic Valve
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Leaky Aortic Valve

At age 37 I had an echocardiogram everything was fine, I'm now 63 years old after another echocardiogram my doctor informed me I have a leaky aortic valve, for now he wants to monitor it yearly.  
Is there anything that I can do  (diet, exercise, vitamins, etc.) that may heal this valve or at least slow down the inevitable?
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Avatar_f_tn
Unfortunately, no.  You will make medical history if you find a way to reverse the course of a deteriorating aortic valve, so let us know.  You can do some other things to help yourself, though.  Keep yourself in the best physical shape possible.  Exercise (within any assigned medical limits) and eat right.  You will be better off  for it, regardless of the valve, and if you do have to have surgery, you will recover better.  Keep those yearly monitoring appointments, and use the time you've been given to figure out who you want to do your surgery, if and when you do have to have the valve replaced.  Ask for imaging (usually done by CT) of the entire aorta, all along its length, at least once, to rule out aortic aneurysm.  Aortic aneurysm is often found along with a leaky aortic valve -- not always, but sometimes.  If any enlargement of the aorta is found, you will need to have that monitored yearly, also; if not, then you may never have to have another CT scan of the aorta.  Good luck.
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Avatar_f_tn
I have a leaky aortic valve also, discovered when I was a year or two younger than you. In the echo, you can see that the leaves of my aortic valve do not close tightly, due to some irregularity on the edges (deposits of some kind, maybe calcium, maybe protein) and there's a bit of backflow into the heart.  Not much, but since the aortic valve is one that ideally should *not* be leaky--in contrast to the others--that discovery earns me a stress test and echo every year or so.  Maybe surprisingly, the regurgitation has not changed significantly in almost a decade.

So far, I'm passing my tests with flying colors, and my doc says, "See you in the next year or two.'  I go to the gym three to five times a week and work out fairly seriously, and in general I feel great.

The exact causes of aortic regurgitation are really not known yet, though certain autoimmune diseases might be involved. There is no cure for a leaky aortic valve, either, though diet and exercise are a good idea in general.  If your condition worsens, surgical replacement of that valve is fairly common these days and usually quite successful.

My doc has told me that he bets that since my valve seems to be stable, there is a good chance that this old, battered model might just 'see me through.'  In any case, since my life is good and I am comfortable, I'm not worried.
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Avatar_m_tn
Do you follow any kind of diet and take supplements?
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Avatar_f_tn
I eat normal food, including meat, nothing special, and take just a one-a-day vitamin (but the most recent research--you probably saw this on the news in the last couple of days--indicates that even that is probably useless for most people).

I have gone to the gym at least every other day for over thirty years, though, and that probably has been the most helpful thing in maintaining reasonably good health for a long time.
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Avatar_m_tn
I saw the news report about vitamins however the news media has an agenda and I don't believe much of what they say.  I'm a big believer in the power of vitamins because I've experienced what they can do.    At age 37 my doctor discovered I have an irregular heartbeat after numerous tests they decided to just monitor it yearly.   In my early 50's after much research I started a vitamin regimen at around age 56 after taking another stress test the irregular heartbeat was gone, not a skip.  My doctor couldn't believe it, when I told him what I did he asked for a list of the vitamins I was taking and he flat out told me he believed the vitamins worked.  In fact, the young girl who did the echocardiogram at the hospital told me she had an irregular heartbeat and was able to get rid of it by taking magnesium and a few other vitamins.

Unfortunately now at age 63 he discovered the leaky heart valve and the skip is back. Maybe I'm just fooling myself but I want to believe if a person can get the right combination of vitamin rich, oxygen rich blood flowing through the heart it just might stop further deterioration of the valve.
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Avatar_m_tn
CT scan of the aorta is that something I should do now or can it wait until my next echocardiogram which is next December?
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Avatar_f_tn
There's no hard and fast rule that I know of about the timing of CT to rule out thoracic aortic aneurysm.  Some doctors don't even think it's worth doing until it's time (if ever) for valve replacement surgery.  If your cardiologist hasn't ordered it, he may be of that mindset.  If it's not something that particularly worries you, then, sure, wait until next year.  

If you were a loved one of mine, though, I wouldn't want you to wait longer than the next echo to ask for the aorta to be evaluated.  Get any problems there ruled out and be done with it, is my thought.  The thing is, if an aneurysm is present, it could as easily be the aneurysm as the leaking valve that ends up needing surgery first.  (Generally, if either problem needs surgery, then both are fixed at the same time.)

Personally, knowing what I know now, I wouldn't be comfortable with the thought that there could be a second issue that needs monitoring just as much as the valve does.  Hopefully there's not an aneurysm, but there's only one way to find out, and that's to look.  I had a root/ascending aneurysm myself, along with a leaking aortic valve, so I know that it does happen.  Bicuspid aortic valves, in particular, are often associated with thoracic aortic aneurysm.  It's an issue of which not every cardiologist is highly aware.

You know, I've only mentioned CT so far, but I believe the abdominal aorta can be examined by means of ultrasound.  That's a cheaper test and doesn't require any exposure to ionizing radiation.  I had CT of both the chest and abdomen myself, because I did not find out about either the leaking valve or the aneurysm until it was actually time for surgery, and CT of both the chest and abdomen is a standard part of the presurgical work-up.  But maybe you would have access to ultrasound screening for abdominal aortic aneurysm by virtue of being in your 60's, and so maybe you could do that part sometime this year, and then maybe the CT of the thorax could wait until you see the cardio again.  

Really, I think a lot of this is up to your own judgment and what you are comfortable with, since your cardiologist is not pushing it.  I'm just throwing some thoughts out.  My main point is that there's a whole aorta that's connected to the aortic valve, and when one of the two goes bad, sometimes both of them go bad -- not always, but sometimes.  And sometimes, as with Achillea's situation, there is a "problem," but it's not disabling, and everything remains stable for many years, and if Achillea's luck continues to hold (we will all hope), she may never need heart surgery.  

On another forum, I have seen posts from people who had aortic valve problems and/or thoracic aneurysms but whose measurements, like Achillea's, did not change for a long, long time.  I've also seen posts from people whose cardiologists were very diligent about monitoring the aortic valve but never suggested checking the rest of the aorta, and then it turned out that there was, in fact, an aneurysm.  That, plus my own experience, is where I'm coming from. Take this all with a grain of salt.
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Avatar_m_tn
This question will just prove my ignorance of the subject but I'll ask anyway.  My doctor performed a nuclear stress test would that detect an aneurysm?
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Avatar_f_tn
I'm pretty ignorant about the nuclear stress test myself, but from what I understand, the sole the purpose of it is to examine the perfusion of the heart muscle.  In other words, is your heart muscle getting good blood flow.  It is a test would relate to the condition of your coronary arteries and the ability of the coronaries, as well as the smaller arterioles and capillaries, to deliver an adequate blood supply to the heart muscle.  It does not particularly tell you anything about the structure of the heart and definitely nothing about the aorta.  Maybe Achillea will chime in here; I'm pretty sure she knows more about nuclear stress tests than I do.  

I can tell you for sure, though, that having gone through two surgeries on my aortic valve and ascending aorta, I've  never had any kind of stress test.  Never had the treadmill test, the chemical stress test, or the nuclear stress test.  The doctors were just not interested in a stress test for me.  I don't have any kind of functional coronary artery disease, so I haven't needed any tests for that except for a presurgical angiogram.  If you're having valve surgery, they do an angiogram beforehand, just to make sure they don't need to do a coronary artery bypass at the same time.  It's routine, just like the presurgical CT of the chest and abdomen is routine.

A regular transthoracic echocardiogram, where they put the echo wand directly on the outside of your chest, gets a pretty good look at the chambers of the heart, the valves, and sometimes the first couple of centimeters of the ascending aorta.  It can pretty well tell if the anatomy of the heart is normal.  It looks at the overall structure of the organ itself.  I assume that's how your doctor found out that your aortic valve was leaking.  To look at the rest of the aorta, you need other types of imaging that it sounds like you have not had.  

Transesophageal echo (TTE) can sometimes see the ascending aorta and I think maybe the aortic arch or at least part of the arch.  TTE is a test in which the echo probe is inserted down your esophagus.  You have to be sedated for it, naturally.  It's an unpleasant test to go through, and the ability to visualize the aorta is still iffy.  I don't think it can "see" the descending aorta at all, and it doesn't always give a clear picture of even the ascending aorta.  What it is usually used for in cases of AV disease is to get a clearer picture of the aortic valve and aortic root than the transthoracic echo can provide.  Transesophageal echo does do a pretty good job of that.  It's usually only done when the patient is at the point of needing AV surgery.  It would be another routine presurgical test.

CT scan and MRI are the tests that are used to rule out thoracic aortic aneurysm.  CT scanning is a bit cheaper than MRI, although it is still expensive.  I believe it gives a more accurate measurement of the aortic diameter than MRI.  CT scanning exposes you to a pretty high dose of ionizing radiation, though.  You don't want to have very many CT scans in your life, if you can help it.  If someone has a thoracic aneurysm that needs annual monitoring but is nowhere near surgical criterion, some doctors will use CT for the initial pics and then MRI for the annual follow-ups.
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Avatar_m_tn
Thank you so much for the valuable information you are very knowledgeable on the subject, you have given me a better understanding of the situation.
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Avatar_f_tn
You're welcome.  The only other comment I have at this time is that there probably ARE lifestyle practices that make a difference in how quickly a bad aortic valve will deteriorate, but medical science just hasn't identified what they are.  As far as I know, the best anyone can tell you right now is just to live a healthy life, eat right, exercise, and keep yourself in the best shape possible.  That way, if you do ever have to have surgery, you should be able to tolerate the surgery and recover from it well.  Maybe those things do have some ability to delay the need for surgery; no one really knows, but it does kind of stand to reason.  If you take any supplements that you notice are of definite benefit to you, take them, and maybe they will help your valve as well.  Just because no one knows of anything that definitely helps the valve does not mean that there is not anything.  Good luck, and keep us posted.
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