Bicuspid Aortic Valve: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Bicuspid Aortic Valve?
A cardiologist, a doctor who treats heart problems, cares for people with this valve. Some adults do best with a cardiologist who has special training in heart conditions people are born with. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Bicuspid aortic valve?
A bicuspid aortic valve is an aortic valve that has only two leaflets instead of three. The aortic valve controls blood flow from the heart into the aorta, the large blood vessel that carries oxygen-rich blood to the body. Leaflets are the small flaps that open and close with each heartbeat.
The valve forms before birth, in the early weeks of pregnancy while the baby's heart is developing. The cause is unclear, but it is the most common heart problem present at birth. It often runs in families, and it is more common in males than females.
Symptoms
Most people have no symptoms for years, and some never learn they have it. The valve can leak or narrow over time, and symptoms may then appear.
- Chest pain.
- Trouble breathing.
- A fast or irregular heartbeat, also called palpitations.
- Fainting.
- Pale skin.
- In babies and children: tiring easily.
Causes and who gets it
The valve problem is there at birth. The cause is unclear, but it often runs in families.
Over time, a two-flap valve can leak blood backward into the heart, called aortic regurgitation, or become stiff and narrow, called aortic stenosis. The aorta itself may also grow large, and in some patients this needs surgery.
How doctors diagnose it
A doctor may first hear a heart murmur, an odd sound heard between heartbeats, during an exam. The echocardiogram is an ultrasound. It views the heart structures and blood flow inside the heart. Other tests may include a chest X-ray, an electrocardiogram (also called an ECG, which records the heart's electrical signals), and an MRI, a scan that gives a detailed picture of the heart.
Treatment
Treatment depends on how much the valve leaks or narrows. Medicine may ease symptoms or prevent problems. These include drugs that lower the workload on the heart, such as beta-blockers and ACE inhibitors, and water pills, called diuretics, that clear extra fluid from the body.
If the valve becomes very leaky or very narrow, it may need repair or replacement. A narrow valve can sometimes be opened with cardiac catheterization, a procedure in which a thin tube is guided to the heart and a balloon on its end is inflated to widen the valve opening. Replacement once required open-heart surgery only, but in adults it can now sometimes be done with a catheter. This is called transcatheter aortic valve replacement, or TAVR. The aorta may also need repair if it becomes too wide or too narrow.
When to see a doctor
Call 911 or go to the emergency room for chest pain, trouble breathing, or fainting, or if a baby or child turns blue or grey. See a doctor for a fast or irregular heartbeat. If your baby will not eat, seems pale, or tires easily, call the child's doctor.
Even a mildly abnormal aortic valve raises the risk of infective endocarditis, a serious infection of the heart's inner lining. Good mouth care and regular dental visits help prevent it. Antibiotics before dental work are not routine, but your doctor may prescribe them in some cases. See your cardiologist for regular checkups, since the valve and the aorta can change over time.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can track your heart health between cardiologist visits, keep an eye on your test results, and coordinate referrals. They can also help manage related problems such as high blood pressure over time.
Common questions
Can a bicuspid aortic valve be prevented?
There is no known way to prevent it, because the valve forms before birth. It runs in families, so tell your doctor if it is in your family, especially before you get pregnant.
Is a bicuspid aortic valve dangerous?
Many people never have problems, but the valve can leak or narrow over time. Complications can include heart failure, leakage back into the heart, and infection of the heart muscle or the valve. The aorta can enlarge in some patients. Regular monitoring helps catch changes early.
What is TAVR?
TAVR stands for transcatheter aortic valve replacement. A doctor threads a thin tube through a blood vessel to the heart and places a new valve inside the old one. It can treat a narrowed aortic valve without open-heart surgery in some adults.
Will I need surgery?
Not everyone does. Many bicuspid valves work well for years. Surgery or a catheter procedure is an option when the valve gets very leaky or very narrow, or when the aorta grows too wide. Your cardiologist will watch your heart over time and talk with you about timing.
Sources
- MedlinePlus Medical Encyclopedia - Bicuspid aortic valve
- American Heart Association - Aortic Valve Stenosis and Congenital Defects
- National Heart, Lung, and Blood Institute - Heart Valve Diseases Treatment
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
