What is aortic valve calcification?

Aortic valve calcification is actually a congenital aortic valve disease. It has no obvious symptoms in early childhood, but may manifest as palpitations, angina pectoris, or shortness of breath in later stages. In addition, due to severe insufficiency of coronary artery blood supply, the symptoms of angina pectoris are aggravated.

1. Congenital aortic valve disease

The most common form is bicuspid valve deformity, with aortic valve stenosis as the main clinical manifestation. The transvalvular pressure gradient during aortic valve systole often exceeds 13.3 kPa (100 mmHg). The electrocardiogram shows high left ventricular voltage, often accompanied by strain. X-ray angiography and ultrasound examination often show that the left ventricular cavity is small and the myocardium is concentrically hypertrophied. Severe aortic stenosis may cause relative mitral regurgitation due to excessive left ventricular systolic pressure.

Another common congenital aortic valve disease is aortic valve leaflet prolapse resulting in aortic regurgitation, which often occurs in cases of large high ventricular septal defect or aortic valve sinus aneurysm rupturing into the right ventricle. In cases of larger high-position ventricular septal defect, the corresponding valve leaflets above it lose support from the ventricular septum, and the valve leaflets prolapse into the right ventricle through the ventricular septum during ventricular diastole. In cases of ruptured sinus of Valsalva aneurysm, the corresponding aortic valve leaflet prolapses into the left ventricle.

2. Aortic valve disease

About 20% of rheumatic mitral valve disease is accompanied by aortic valve disease. In rheumatic heart disease, simple aortic valve disease is rare. The three leaflets of the aortic valve are all fibrotic, thickened, contracted, hardened, and even calcified, with very poor mobility. Therefore, rheumatic aortic valve disease is often a double lesion of stenosis and insufficiency, with a long course of disease and more serious heart function damage.

3. Degenerative changes of aortic valve

The aortic valve leaflets show myxoid changes, the tissue is thin and translucent, and cannot withstand the diastolic pressure in the aorta, resulting in insufficiency. It is common in ascending aortic aneurysms caused by syphilitic aortitis, Marfan syndrome, medial aortic necrosis, senile degenerative changes and other reasons. Due to severe incompetence of the aortic valve, the pulse pressure of the peripheral arteries was significantly widened. In terms of hemodynamics, the left ventricle had a severe volume load increase, so the left ventricle enlarged to the left, downward, and backward. Both left ventriculography and ultrasound examination showed that the left ventricular cavity was significantly enlarged and the aortic valve had severe regurgitation. The contrast agent flows back and forth in the left ventricle and ascending aorta, where it stays for a long time and cannot be emptied quickly.