Valvular Heart Disease

What is Valvular Heart Disease?

Valvular heart disease is the general term applied to any dysfunction or disease of any of the four valves of the heart.

In a healthy heart, the four valves keep the right amount of blood flowing in one direction, either into or away from the heart, and at the right time. The valves are the mitral and aortic valves, on the right side of the heart, and the tricuspid and pulmonic valves on the left side. Most valvular disease occurs in the mitral or aortic valves.

Types of Valvular Heart Disease

There are four main types of valvular heart disease:

  • Valvular stenosis – Valve narrows, hardens, or becomes blocked, and interferes with blood flow.
  • Valvular regurgitation – Valve does not close completely, allowing blood to leak in the wrong direction.
  • Atresia – Birth defect where the valve does not fully develop or is completely closed at birth.
  • Mitral valve prolapse – Mitral valve cannot close properly and allows blood to leak back into the left atrium.

Symptoms of Valvular Heart Disease

Early valvular heart disease usually shows no symptoms, or has symptoms that can easily be mistaken for other conditions. Mild symptoms may include fatigue, feeling heart palpitations, chest pain (angina pectoris), changes in blood pressure.

If certain types of valvular heart disease goes untreated, heart failure may develop. Symptoms of heart failure include excessive, unexplained coughing, shortness of breath and swollen legs/feet.

Causes of Valvular Heart Disease

Historically, the main cause of valvular heart disease has been rheumatic fever. However, due to vaccines and antibiotics, rheumatic fever has been almost eradicated in most western countries. Today, the main people who suffer from valvular heart disease caused by rheumatic fever are the elderly who did not receive the antibiotics to fight rheumatic fever in their youth.

More common causes of valvular heart disease include heart attack (causing mitral valve regurgitation), birth defect, or severe lung disease.

Diagnosing Valvular Heart Disease

Typically your doctor can diagnose valvular heart disease in a routine physical exam by listening to your heart through a stethoscope. By listening to the way blood is pumped through the heart and listening for a heart murmur or any other sounds, the doctor can determine if the heart valves are functioning properly or if there is a need for further tests.

Additional diagnostic tests may include:

  • Electrocardiogram (EKG) -The heart’s electrical impulses are recorded and measured to indicate the presence of arrhythmia.
  • Chest x-ray – Allows doctor to see a picture of your heart and other potentially affected organs.
  • Echocardiogram – Shows size and shape of the heart.
  • Cardiac catheterization – Shows how well blood is flowing and pumping through the heart and if there are any blockages.

Treatment Options

Treatment of valvular heart disease depends upon the type and severity of the disease.

Medication

Valvular heart disease usually responds well to medications such as:

  • ACE inhibitors – Widen blood vessels and lowers blood pressure.
  • Antiarrhythmics – Help maintain a regular heart beat, pumping blood through the body more efficiently.
  • Anticoagulants – Prevent blood clots.
  • Cardiotonics – Cause the blood to pump through the heart more forcefully.

Surgery

If medication is unsuccessful or inadequate, surgery may be required. Possible treatments include:

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