Diagnosis of BAV

DOCTOR'S VIEWS ARCHIVE

Topic: Bicuspid Aortic Valve

Dr. Lee:
How do you diagnose bicuspid aortic valve?

Dr. Michael Miyamoto:

Bicuspid aortic valve in asymptomatic patients can be difficult to diagnose, so there are no symptoms to rely upon. The physical examination may demonstrate a murmur. Either a murmur caused by relative narrowing of the valve, which would occur as the heart is pumping blood through the valve, or the murmur may be of the valve leaking, which may occur after the heart has pumped when the blood flows backwards from the aorta into the left ventricle. Then, the bicuspid valve in an asymptomatic patient may be demonstrated to the abnormal by an echocardiogram, which is an ultrasound of the heart, where the valve structure can be directly visualized with ultra sound. There are clues that the valve may be bicuspid and not be the normal tricuspid structure. And often or sometimes, it is not completely clear whether the valve is bicuspid or not as there can be a raze or a vestige of the third comiture that has fused or never completely opened, such that it may look like from certain views, that the valve is tricuspid. When you carefully look at the valve and see how it opens, you see that there are only two functional leaflets.

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