Bicuspid aortic stenosis natural history

Natural History
Bicuspid aortic valve, during childhood functions without any significant pressure gradient. However, the thickening and calcification of the valves may be detectable pathologically and on echocardiography by second decade. This progresses to aortic stenosis requiring operative correction in approximately 75% of cases.

Bicuspid aortic stenosis progressively leads to heart failure, arrythmias, angina and other symptoms which generally manifests between 40 to 60 years of age which is relatively younger to manifestation of aortic stenosis otherwise. However, children who develop early pathologic changes in bicuspid aortic valve are more likely to develop aortic insufficiency than stenosis.

Complications
Bicuspid aortic valve disease is associated with the following complications:
 * Aortic stenosis in the majority (75%) of patients.
 * Aortic insufficiency
 * Endocarditis
 * Aortic aneurysm
 * Aortic dissection
 * Sudden death can occur in children during and immediately after exertion especially among those with pressure gradient > 50 mmHg across the aortic valve.

For complications of aortic stenosis, click here