Bicuspid, nothing to do with teeth

Bi means two

bicuspid aortic valveWhen I had to have a physical for the military draft in October 1972, I told the doctor that my pediatrician said I had a minor heart murmur. The doc double-checked me and pronounced that he wouldn’t have even noticed had I not mentioned it. (No, I never was in the military. Long story.)

My primary care physician (PCP) has noted for years that I’ve had a regularly irregular heartbeat. But this year, something in some tests she ordered concerned her enough to request some more. Then I met with a cardiac surgeon who started talking about surgery. What? Still, he ordered a CT scan and echocardiogram.

Let me say here that at that moment, I’m convinced I’m about to die. My blood pressure is abnormally high at both the cardiologist’s office and at the tests. The only time my BP before was over 150 systolic was before my hernia operation in 2015. But as it turns out while there is a slight thickening of the aortic wall, it was something that needed to be monitored but not yet treated, surgically, for about five years.

Bicuspid aortic valve

But it wasn’t until I got to my PCP a couple weeks later that she told me that I have a congenital bicuspid aortic valve. What does THAT mean? “The aortic valve — located between the lower left heart chamber (left ventricle) and the main artery that leads to the body (aorta) — has only two (bicuspid) cusps instead of three.”

OK. “A bicuspid aortic valve may cause the heart’s aortic valve to narrow (aortic valve stenosis). This narrowing prevents the valve from opening fully, which reduces or blocks blood flow from the heart to the body.” Hmm, that must be plain English for what those tests showed.

“In some cases, the aortic valve doesn’t close tightly, causing blood to leak backward into the left ventricle (aortic valve regurgitation). Most people with a bicuspid aortic valve aren’t affected by valve problems until they’re adults… Some may not be affected until they’re older adults.” Lessee, I guess that includes me.

“Some people with a bicuspid aortic valve may have an enlarged aorta — the main blood vessel leading from the heart. There is also an increased risk of aortic dissection.” I heard mention of that! Meaning?

Waiting to exhale

“An aortic dissection is a serious condition in which the inner layer of the aorta, the large blood vessel branching off the heart, tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). If the blood-filled channel ruptures through the outside aortic wall, aortic dissection is often fatal.” Oh, joy.

“Aortic dissection is relatively uncommon.” That’s good. “The condition most frequently occurs in men in their 60s and 70s.” Ah, my demographic! “Symptoms of aortic dissection may mimic those of other diseases, often leading to delays in diagnosis. However, when an aortic dissection is detected early and treated promptly, the chance of survival greatly improves.”

I suppose this means I ought to get one of those tags noting my bicuspid aortic valve. Otherwise, I may get treated for the heart attack I’m possibly not having at the time.

Let’s not get ahead of myself

People “with a bicuspid aortic valve will require regular monitoring for any changes in their condition, such as valve problems or an enlarged aorta, by doctors trained in congenital heart disease (congenital cardiologists). You may eventually need treatment for valve problems such as aortic valve stenosis, aortic valve regurgitation, or an enlarged aorta.

“Depending on your condition, treatment may include aortic valve replacement” or other surgeries. The point is that I will need “lifelong care from a congenital cardiologist… including regular follow-up appointments to monitor for any changes in your condition.”

Oh, and “a bicuspid aortic valve can be inherited in families. Because of this, doctors often recommend that all first-degree relatives — parents, children, and siblings — of people with a bicuspid aortic valve be screened with an echocardiogram.” In this case, my sisters and my daughter.

Yes, I’m still a bit weirded about this. Worrying is unhelpful, I suppose. But YOU tell my subconscious that.

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