Aortic valve and aneurysms

Download the Issue @ a Glance podcast Subscribe to the EHJ Podcast ![Graphic][1] The aorta is the highway in the human circulation, and accordingly any functional or structural change is associated with severe symptoms or even a fatal outcome. The aortic valve is the door to the aorta and it opens up to 3 billion times in a lifetime. If not perfectly built by nature, e.g. in biscuspid valve disease1 or tricuspid valves with raphe, aortic sclerosis and eventually stenosis are the result.2 Similarly, the aorta itself can change with age and remodel, and eventually develop aneurysms in its thoracic or abdominal part. This issue of the journal is devoted to the aortic valve and in particular the management of patients after valve implantation, as well as the treatment of abdominal aortic aneurysms, a common and potentially fatal disease particularly in male smokers.3,4 This focus issue begins, however, with a timely Clinical Review article on a slightly different topic, i.e. ‘ Sudden cardiac death in the young: the molecular autopsy and a practical approach to surviving relatives ’ by Chris Semsarian from the Royal Prince Alfred Hospital in Camperdown, NSW, Australia.5 Sudden cardiac death of a young, apparently fit and healthy individual is a particularly devastating event for the patient's family and treating physicians alike. While coronary artery disease and acute myocardial infarction are the most common causes of sudden cardiac death in older populations, genetic cardiac conditions comprise a substantial proportion of such cases in those aged ≤40 years. These include arrhythmogenic disorders such as the long QT syndromes, and inherited cardiomyopathies, namely hypertrophic cardiomyopathy. In up to 30% of young sudden cardiac death, no apparent cause of death can be found, i.e. so-called ‘autopsy negative’ or ‘sudden arrhythmic death syndrome’. Management of families … [1]: /embed/inline-graphic-1.gif