BICUSPID AORTIC VALVE; PATIENT POINT OF VIEW
My name is Lahouaria, and I am 46 years old as I write these lines. I was born with an aortic heart valve defect, more usually referred to in this case as Bicuspid Aortic Valve (BAV).
Over the years, this anomaly caused a moderate narrowing of the aortic valve. The deterioration is likely due to an inflammatory process, damaging an abnormally formed aortic valve.
The aortic valve allows blood to flow from the heart to the aorta; it is made up of 3 cusps or leaflets. These cusps are highly supple and may be compared to inverted small parachutes. The narrowing prevents the valve from oprning fully, which reduces or blocks blood flow from the heart to the left ventricule.
In the case of a bicuspid aortic valve, the work is done by 2 cusps only, instead of 3.
Today, I would like to tell you about my life with this type of congenital heart defect.
A perfectly normal childhood
I was born in Algeria, and during her pregnancy, my mother did not recur to proper medical monitoring.
The birth occurred suddenly, at home. Everything appeared normal and I enjoyed a regular childhood.
I never complained about any discomfort during physical activity.
Unexpected discovery of a heart murmur
When I was 4 years old, my mother worked as an assistant cook in a Chinese business. She brought me to her workplace for a first medical check-up as there was a compamy doctor on the premises. It was at that moment that my heart murmur was discovered.
A heart murmur is heard through a stethoscope. The doctor recommended that I see a cardiologist because that condition could be due to several causes.
Consultation with a cardiologist
The cardiologist did not give us many details regarding my problem, but he did confirm that I had a heart murmur.
It is not unusual for some children to have a heart murmur... and it is very likely that this doctor was not overly worried about my case.
I was living in a city and my mother looked after medical expenses with her private insurance. Be that as it may, I was a child in good health and I grew up without any problem.
My arrival in Canada
In November 1999, at the age of 25, I emigrated to Canada to be with my significant other.
I unferwent a medical examination and everything was found to be normal. I was pregnant some 3 months later.
In Canada, pregnancies are subject to well-structured monitoring. My heart murmur showed up again right at my first pregnancy consultation. I had put that anomaly way behind me as I had no symptoms whatsoever and felt totally well.
It was then that an aortic bicuspid was diagnosed.
Another consultation with a cardiologist
My gynaecologist at St. Luc Hospital, in Montreal, referred me to a cardiologist in order for me to have an echocardiography done.
The cardiologist explained that the test showed a malformation at the artic valve level and that it was a congenital defect; in other words, I was born with this abnormality. At the time, the valve opening did not show any narrowing, so no aortic valve stenosis was detected.
The cardiologist reassured me, the defect would not prevent my pregnancy from continuing. He added also that I could have other pregnancies in the future without any problem.
It would be necessary, however, to follow my condition closely with cardiac echographies done from time to time. For my part, I am to maintain good oral hygiene as a bicuspid aortic valve is more prone to infection. A meticulous oral hygiene helps prevent this kind of complication.
A trouble-free first pregnancy
Both my pregnancy and childbirth went smoothly, and so did the postpartum period. I gave birth to a healthy baby girl: weight was 3 kg 200, length 52 cm.
An active woman
I have always been an active woman and my cardiac anomaly did not prevent me from pursuing my activities.
I started having chest pains in 2012 and went to Hôtel-Dieu Hospital, in Montreal. Several blood tests were done, as well as an electrocardiogram, a lung X-ray and a cardiac echography. The doctor informed me afterward that I had a moderate aortic stenosis, that is to say a narrowed aortic valve.
Regular medical follow-up and 2 more pregnancies
My medical follow-up appointments have since then become very important for me and for my doctors. I wanted to have a second child, and as a precautionary measure, I consulted my cardiologist first so as to have his advice and authorization. He reassured me, saying he did not foresee any difficulty in my doing so, and I went ahead with a new pregnancy.
My second pregnancy went as well as the first one with close monitoring by my attending physicians.
One year later, I gave birth to my third child, and once more all went very well. I do not have the right words to thank the medical team that looked after me throughout my pregnancies, including my cardiologist, of course.
I am now the mother of 3 daughters. My pregnancies and giving birth went well and my cardiac problem was never a handicap.
My children are big girls now, 20, 7 and 6 years old, and they are perfectly healthy.
My electrocardiographies show that my aortic valve did not deteriorate further since I was first diagnosed with moderate aortic valve stenosis.
Possibility of aortic valve replacement surgery
It is my earnest wish that my aortic valve remains stable for a long time to come, otherwise it will have to be replaced. Currently, open-heart surgery would be used.
Lately, however, catheter surgery is proving more and more successful in the replacement of a narrowed aortic valve. It is not a surgery as such because the chest cavity or thorax is not opened. In a not too distant future, it is foreseeable that this new technique will become the standard procedure used in aortic valve replacement.
Sometimes, when I go to bed at night, I fear not waking up the next morning because my heart is overly tired. I have no doubt that if I still lived in my native country, I would be dead by now on account of my cardiac defect and my three pregnancies.
My fear subsides, as I recall my cardiologists's reassuring words. I can enjoy a full life without major restrictions. "Everything in moderation", that's the rule.
A lucky woman
I feel very fortunate to be living in Canada with my husband and my three precious daughters, and to have access to excellent medical care.
I can honestly say that my bicuspid aortic valve defect never prevented me from living a full life and having ambition in everything I undertake.
I pay close attention to my physical and mental health, my diet and my oral hygiene.
I hope that my experience has shed a light on what to expect when living with an aortic valvular defect. Never hesitate to ask whatever questions you may have and that worry you. It is unwise to remain in doubt.
It is possible to live a normal life!
There are plenty of things one can do to stay away from hospitals, namely, adopting healthy living habits, eating a balanced diet, staying active, practicing oral hygiene and getting involved in one's medical follow-up.
READ MORE: BICUSPID AORTIC VALVE; MEDICAL POINT OF VIEW