The aortic valve sits between the left ventricle and the aorta. It has three half-moon (semilunar) cusps, named right coronary, left coronary and non-coronary after the coronary artery openings in the sinuses just above them. It has no chordae; the cusps close passively when blood falls back towards the ventricle.
| Location | At the aortic orifice, behind the left half of the sternum at the level of the third intercostal space. It is best heard at the right second intercostal space. |
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Lets blood leave the left ventricle during systole and stops it falling back during diastole. Its closure forms the main part of the second heart sound, and backflow into the sinuses helps fill the coronary arteries.
Calcific aortic stenosis is the most common valve disease needing intervention in older adults, and is now often treated by catheter valve replacement (TAVI). About 1-2% of people have a bicuspid aortic valve, which tends to narrow or leak earlier and is linked to aortic dilation. Symptoms of significant stenosis include exertional chest pain, breathlessness and fainting, so unexplained exercise intolerance in older adults deserves assessment.
Narrowing of the valve, usually from age-related calcification or a bicuspid valve. Once symptoms appear, outlook without valve replacement is poor.
Leakage of blood back into the left ventricle during diastole, caused by cusp disease or a dilated aortic root. It produces a wide pulse pressure and gradual ventricular dilation.
A congenital valve with two cusps instead of three. It is the most common congenital heart abnormality and predisposes to stenosis, regurgitation and aortic aneurysm.
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