Aortic Valve Disease Treatment in Malaysia

What is Aortic Valve Disease?

Aortic Valve Disease occurs when the aortic valve does not open or close normally. In aortic stenosis, the valve becomes narrowed and restricts blood flow from the left ventricle to the aorta. In aortic regurgitation, the valve does not close completely, allowing blood to flow backwards into the left ventricle. The condition may develop because of age-related calcification, a bicuspid aortic valve, rheumatic heart disease, infection, or other structural abnormalities.

What is the Importance of Timely Treatment?

Timely evaluation helps determine the type and severity of aortic valve disease, assess heart function, control symptoms, and identify when monitoring, medicines, valve repair, or valve replacement may be appropriate. Treating significant disease can help reduce the risk of complications such as heart failure, abnormal heart rhythms, fainting, and other cardiovascular problems.

What are the Common Symptoms of Aortic Valve Disease?

• Shortness of Breath: Breathlessness may develop during physical activity and can become more noticeable as valve disease progresses.
• Chest Discomfort: Aortic stenosis may cause chest pressure, tightness, or discomfort, particularly during exertion.
• Fatigue: Reduced forward blood flow or increased cardiac workload may cause tiredness and reduced stamina.
• Dizziness or Fainting: Reduced blood flow during activity can cause lightheadedness or fainting, particularly in significant aortic stenosis.
• Reduced Exercise Tolerance: Routine physical activities may become increasingly difficult because of breathlessness or fatigue.
• Palpitations: Some people may experience a fast, pounding, or irregular heartbeat, particularly when associated rhythm abnormalities develop.

Causes and Risk Factors of Aortic Valve Disease

Causes

• Age-Related Calcification: Calcium deposits and progressive thickening can stiffen and narrow the aortic valve.
• Bicuspid Aortic Valve: A congenital valve abnormality in which the aortic valve has two leaflets instead of the usual three can lead to stenosis or regurgitation.
• Rheumatic Heart Disease: Rheumatic fever can cause long-term damage and thickening of the aortic valve.
• Infective Endocarditis: Infection of the valve can damage its leaflets and cause regurgitation.
• Congenital Abnormalities: Structural abnormalities present from birth can affect aortic valve function.
• Aortic Root Disease: Enlargement or structural abnormalities of the aorta can prevent the valve from closing properly and cause regurgitation.
• Connective Tissue Disorders: Certain inherited connective tissue conditions can affect the aortic valve or aortic root.
• Previous Cardiac Procedures or Radiation: Some treatments can contribute to later structural valve changes.

Risk Factors

• Older age
• Bicuspid aortic valve
• Previous rheumatic fever or rheumatic heart disease
• High blood pressure
• High cholesterol
• Smoking
• Diabetes
• Chronic kidney disease
• Previous infective endocarditis
• Family history of certain valve or aortic conditions
• Certain congenital or connective tissue disorders

Latest Research and Technologies in the Treatment of Aortic Valve Disease in Malaysia

• Recent advances in aortic valve disease treatment in Malaysia include improved 3D echocardiography, cardiac CT for detailed valve assessment and procedural planning, and less invasive valve replacement techniques. Transcatheter aortic valve implantation (TAVI/TAVR) allows selected patients with severe aortic stenosis to receive a replacement valve through a catheter, often avoiding open-heart surgery. Surgical aortic valve replacement and, in selected cases, valve repair or balloon valvuloplasty remain important treatment options. Advances in valve design, imaging-guided procedures, and multidisciplinary Heart Team assessment help clinicians tailor treatment to the patient's age, symptoms, anatomy, and surgical risk. Access to specific procedures varies between Malaysian cardiac centres.