Bicuspid aortic valve may not be diagnosed early in most cases as it causes no symptoms. However, over time this valve may begin to leak (regurgitation), become narrowed (stenosed), or has both of these. Calcification of the leaflets may happen. The narrowing of the valve causes the heart to pump harder. A leaky valve allows blood flow back into the heart after it has been pumped out, hence needing the heart to pump more blood forward. Both ways cause the heart to work harder which may lead to heart failure later in life. The symptoms of failing valves include difficulty in breathing, chest pain, fainting (syncope), heart murmur and fatigue.
Prevention of endocarditis
Antibiotic for dental prophylaxis is no longer required for patient with bicuspid aortic valve.
Prevention of Infective Endocarditis (IE)
The incident of IE in congenital patient is higher than general population. Therefore it is important for congenital patient to maintain good oral, dental and skin hygiene as primary prevention. Cosmetic tattooing and piercing are discouraged due to the risk of IE. Antibiotic prophylaxis is considered for patient at highest risk for IE before surgery and dental procedures. Please discuss with your congenital team for the latest update on the antibiotic prophylaxis.
If the aortic stenosis or regurgitation is mild, you are more likely to handle pregnancy well. However, women with severe aortic valve defect have a higher risk and would need to discuss with her cardiologist before contemplating pregnancy.