Bicuspid aortic valve

What is a bicuspid aortic valve?

The aortic valve normally has three separate leaflets (cusps), which come together to form a seal. A bicuspid aortic valve means two of the cusps did not completely separate during fetal development, resulting in a two-leaflet valve. A bicuspid aortic valve is common and will often function normally for many years. It is twice as common in men as in women and can be hereditary.

Causes

A bicuspid aortic valve is something you are born with and can often be the cause of other valve diseases because it means the heart has to work harder to circulate blood. This increased workload causes the heart to “age” faster and be more affected by conditions that lead to other valve diseases. These include high blood pressure, high blood cholesterol, chronic smoking, or diabetes.

Symptoms

Symptoms may be difficult to recognize, as they vary and are often dismissed as general signs of aging. Common symptoms include:

  • Shortness of breath or fatigue

  • Chest pain

  • Fainting

Make sure you monitor any changes using a symptom tracker and attend regular checkups with your healthcare provider.

Treatments

If your valve requires treatment, a range of options may be available. Your heart team should carefully explain the risks and benefits of each approach for you. Together, you and your heart team can make the best decision about the right treatment for you. Treatment options may include:

Surgery

  • Surgical options are similar to those used to treat aortic stenosis or aortic regurgitation from other causes. This means valve repair and biological or mechanical replacements are options. However, TAVI (transcatheter aortic valve implantation) procedures are considered more difficult with bicuspid valves and are not always recommended.

Lifestyle changes

  • With all heart valve diseases, healthy habits can improve your health generally and reduce the strain put on your heart from everyday activities. Maintaining a healthy weight, stopping smoking, and starting light exercise like walking can help your heart adapt to work better despite valve disease.

Medical management

  • Regular checkups to monitor your heart health.

  • Your heart team may prescribe medications to treat your symptoms, reduce complications and/or manage risk factors.


There is a lot to consider when deciding on treatment. These resources will help you ask the right questions and participate in decision making with your heart team.


Patient Stories

If you have been diagnosed with a bicuspid aortic valve, you are not alone. Learn from people who share their experience — and what they learned about diagnosis, treatment and recovery.

Frequently asked questions

What do I do if my doctor detects a murmur?

If your healthcare provider detects a murmur during a regular check-up, they may arrange for you to have one or more follow-up tests to help identify the cause. A murmur is not always a cause for concern. You may have a mild form of heart valve disease or sometimes hearts produce a murmur with no apparent cause. The follow-up tests will determine if you have heart valve disease and how to treat it.

Is a bicuspid valve hereditary and should my children be examined for heart anomalies?

Do all heart valve diseases require surgery?

No. Many Canadians who are diagnosed with heart valve disease can live a normal life with lifestyle changes and minimal treatment. Mild and moderate heart valve conditions may never need surgery. Regular check-ups help identify when heart valve disease is worsening and give you time to consider treatment options.

Resources

Initial Consultation Guide

This guide will help you prepare for an appointment with your doctor and support an efficient, informative, and helpful consultation. It outlines the types of questions your doctor may ask you during the consultation, as well as questions you'll want to consider asking.

Download Initial Consultation Guide

Shared decision making

People diagnosed with heart valve disease are often confronted with a wide range of treatment options. Shared decision-making involves doctors and patients working together to choose the most suitable treatment, based on the patient’s preferences and goals as well as clinical evidence and the care team’s expertise. These resources aim to support people with heart valve disease in participating in decision-making about their care.

Get the shared-decision making guide

Get the Shared decision-making patient checklist

Get the Shared decision-making guide summary

Symptom Tracker

Our symptom tracker has been developed to help people who think they may have heart valve disease, or other cardiac conditions, prior to or during consultation periods with their doctor. It captures symptoms to help you and your doctor understand your health and assist with diagnosis and ongoing care planning.

Download Symptom Tracker

There is life after treatment.

Each person’s path to recovery will look different. Your treatment plan will be unique to your needs, and likewise, your recovery — the time it takes to return to a normal activity level and adapt to lifestyle changes — may vary from what others experience. Taking time to recover, both physically and mentally, is an important part of your journey.