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HEART VALVE DISORDERS
Congenital heart disease comprises a spectrum of defects of the heart present at birth. These defects occur during development of the normal heart in the womb even before babies are born. The crucial period of heart development is in the first 4 weeks of the heart development in womb when it changes from a simple tube like structure to form a complex efficient structure with a pump like action, valves and tubes that carry blood to the entire body and lungs. Although present at birth, on some occasions, congenital heart disease is picked up in later life. Dr Khambadkone will perform an echocardiography and electrocardiography personally and give a diagnosis and management plan at the end of the consultation. Rarely, additional tests such as X ray of the chest, Heart Rhythm monitoring, exercise testing, CT angiogram or Cardiac Magnetic Resonance Imaging may be necessary. These can vary from simple defects such as holes in the heart, diseases of the valve , narrowing of arteries or complex abnormalities of connection and severe anomalies. Narrow heart valves (aortic valve stenosis, pulmonary valve stenosis) increase work load on the heart. Treatment with cardiac catheterization is effective in most cases. ​Some factors are known to increase the risk of congenital heart disease however no obvious cause can be identified in most cases. Maternal diabetes, alcohol intake, infections during the first trimester are all high risk factors for congenital heart disease. Presence of genetic defects in babies such as Down syndrome, Williams syndrome, Noonan’s syndrome, Di George syndrome all have increased risk of congenital heart disease. The risk increases in siblings or children of those with congenital heart disease also suggesting a genetic basis.
BICUSPID AORTIC VALVE
In some children or adults, instead of three leaflets, the aortic valve has only two, and hence called bicuspid aortic valve. Often, there are three leaflets of which two are stuck together at their edge forming a single leaflet and hence forming a two leaflet valve.
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A bicuspid aortic valve needs lifelong monitoring, even in absence of associated defects or aortic valve dysfunction. There is a strong association of bicuspid aortic valve and weakness of the aortic wall that causes it to stretch and increase in size.
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AORTIC VALVE STENOSIS
Aortic valve stenosis describes a condition that causes narrowing of the aortic valve. The aortic valve is an outlet valve that is located in the outlet from the left sided chamber of the heart towards the body artery (aorta) and the body circulation.
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Babies born with very severe narrowing of aortic valve tend to get sick soon after birth (heart failure) and need urgent treatment. When treatment is necessary, Dr Khambadkone will perform a keyhole procedure by cardiac catheterization, balloon aortic valvotomy, stretching the valve with a balloon catheter.
PULMONARY VALVE STENOSIS