From the Guidelines
A bicuspid aortic valve can cause dizziness due to aortic regurgitation, which leads to reduced cardiac output and decreased blood flow to the brain, as indicated in the 2021 ACC/AHA guideline for the management of patients with valvular heart disease 1. The bicuspid aortic valve is a congenital heart defect that can lead to aortic regurgitation, a condition where the aortic valve does not close properly, allowing blood to flow back into the left ventricle. This can result in a decrease in cardiac output, leading to reduced blood flow to the brain and other organs. Some key points to consider include:
- The severity of aortic regurgitation can be classified into different stages, ranging from mild to severe, as outlined in the 2021 ACC/AHA guideline 1.
- The management of patients with aortic regurgitation depends on the severity of the condition and the presence of symptoms, with treatment options including medications, lifestyle modifications, and surgical repair or replacement of the valve in severe cases.
- The 2014 AHA/ACC guideline for the management of patients with valvular heart disease recommends an initial transthoracic echocardiogram (TTE) to evaluate valve morphology and assess the severity of aortic stenosis and regurgitation in patients with a known bicuspid aortic valve 1.
- The 2016 statement of clarification from the American College of Cardiology/American Heart Association task force on clinical practice guidelines provides recommendations for operative intervention in patients with bicuspid aortic valves and dilatation of the aortic root or ascending aorta, including a threshold of 5.5 cm or greater for asymptomatic patients 1. In summary, the bicuspid aortic valve can cause dizziness due to aortic regurgitation, and treatment depends on the severity of the condition and the presence of symptoms, with the most recent and highest quality evidence guiding management decisions 1.
From the Research
Bicuspid Aortic Valve and Dizziness
- The bicuspid aortic valve is a congenital heart defect that affects 1 to 2% of the population 2, 3, 4.
- It may be complicated by aortic stenosis or aortic insufficiency and infective endocarditis 2.
- Aortic wall abnormalities associated with bicuspid aortic valve are due to cystic medial necrosis, which can lead to aortic aneurysm and dissection 2.
- These complications can cause dizziness due to:
- Reduced blood flow to the brain
- Increased risk of stroke or transient ischemic attack
- Arrhythmias or other cardiac complications
- However, the exact mechanism of dizziness in patients with bicuspid aortic valve is not explicitly stated in the provided studies.
- Management of bicuspid aortic valve patients requires continuous surveillance to treat associated lesions and prevent complications 2, 3, 4.
- Valve replacement or repair may be necessary to prevent further complications 3, 5, 6.
- Patients with bicuspid aortic valve should be informed about the benefits and drawbacks of different valve substitutes and management strategies 3.