Bicuspid aortic valve (BAV) is a common congenital heart condition. It can cause a number of symptoms, such as chest pain, shortness of breath, heart palpitations, and more.

BAV occurs when the aortic valve has two cusps instead of the standard three. It can affect blood flow from the heart to the aorta, a major blood vessel, and lead to various symptoms and complications over time. Complications can include heart failure or structural changes in the aorta.

This article overviews BAV symptoms that can occur in children and adults, when to contact a doctor, treatment for BAV symptoms, and some frequently asked questions.

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A bicuspid aortic valve (BAV) is the most common congenital heart defect. Congenital means it is present at birth. According to a 2022 comprehensive review, BAV affects around 1% of the larger population and about 0.5–0.8% of healthy school-aged children and young adults.

In children, symptoms of BAV may not be immediately evident. If any do occur, it is crucial for caregivers to consult a pediatrician.

Signs and symptoms of BAV in children include:

  • Heart murmurs: A heart murmur is an atypical sound that can occur with each heartbeat. It mimics a whooshing sound and occurs when blood does not flow smoothly through the heart. A doctor may detect this during a routine physical examination as the sound can be heard through a stethoscope.
  • Chest pain or discomfort: Chest pain or discomfort may be described as pressure or tightness in the chest, especially upon physical exertion.
  • Fatigue: Unexplained fatigue or a lack of energy could be a symptom of BAV in children.
  • ​​Shortness of breath: Having breathing difficulties, especially during physical exertion, can be a sign of aortic valve dysfunction. This may cause children to have a lower tolerance for physical activity.

If there is a family history of BAV in a first-degree relative, such as a parent, a doctor can screen for BAV in a child using echocardiography. Echocardiography creates pictures of the heart.

As people with BAV age, they may develop more noticeable symptoms. These can include:

  • heart palpitations, which may feel like the heart is racing, pounding, or skipping beats
  • dizziness or fainting, which occur from reduced blood flow to the brain
  • shortness of breath
  • chest pain or discomfort

Experts recommend adults with BAV be vigilant about any new or worsening symptoms. If symptoms develop or worsen, a person should seek medical advice promptly.

If a person does not receive treatment, worsening heart valve problems can lead to complications such as:

It is essential for people with BAV to seek medical attention if they experience any of the following symptoms:

  • severe chest pain or pressure
  • shortness of breath, especially at rest
  • fainting or loss of consciousness
  • rapid or irregular heartbeat
  • sudden weakness or fatigue

Prompt medical evaluation can prevent or manage potentially serious complications associated with BAV, such as:

BAV has no cure, but treatments can help relieve symptoms and restore normal valve function.

The severity of symptoms or associated complications can determine treatment options. Treatment options may include:

  • Monitoring: Regular checkups with a cardiologist are essential to monitor the progression of BAV and detect any changes early.
  • Surgery: In severe cases or when complications occur, surgical intervention is necessary to repair or replace the aortic valve.

Sometimes, medications can help manage other health conditions, such as high blood pressure or high cholesterol, that can worsen regurgitation or aneurysm growth. In these cases, a doctor may prescribe medications such as beta-blockers or ACE inhibitors.

A doctor can advise on the best course of treatment when a child or adult has BAV symptoms.

Learn more about BAV treatment.

Below are some of the most common questions about a bicuspid aortic valve.

How serious is bicuspid aortic valve?

Without treatment, BAV may lead to serious complications, such as aortic valve stenosis, aortic regurgitation, or aortic aneurysm. These conditions can affect the heart or aortic valve’s function.

However, with appropriate medical management and monitoring, many people with BAV lead full and active lives.

What is the life expectancy of someone with a bicuspid aortic valve?

The life expectancy of someone with BAV can vary depending on various factors, including whether complications occur and how effective treatment is. Still, with proper medical care, most people with BAV have a typical life expectancy.

In fact, a 2017 study indicates that long-term survival is excellent in people with BAV. However, researchers note that people with BAV are likely to experience frequent cardiovascular events, such as medical interventions.

A 2021 study found that the life expectancy of people with BAV is similar to that of the larger population.

How often should a bicuspid aortic valve be checked?

People with BAV need regular monitoring by a cardiologist. The frequency of checkups depends on the severity of a person’s symptoms and whether they have complications.

Generally, a doctor may recommend a checkup at least once or twice a year to assess valve function and monitor for any changes. Lifelong monitoring is usually necessary.

Symptoms of BAV can vary depending on a person’s age and the severity of their condition but may include heart murmurs, chest pain, shortness of breath, and fatigue. People may not experience symptoms until later in life.

Regular monitoring is essential to manage BAV and any complications, such as aortic valve stenosis or aortic aneurysms.

In some cases, BAV only needs regular monitoring. In other cases, surgery is necessary. A doctor may prescribe medication to treat other health conditions, such as high blood pressure, that can increase the risk of BAV complications.

Regular monitoring by a cardiologist is essential to ensure optimal health outcomes. With proper medical care, people with BAV can lead full and active lives.