What is heart valve disease?
Heart valve disease happens when one or more of the valves in your heart aren’t working properly. If not treated, it can cause your heart to work harder, reduce blood flow and even become life-threatening over time.
Your heart has four valves that help keep blood flowing in the right direction. These valves are made of tiny flaps of tissue (called leaflets) that open and close during each heartbeat. The leaflets open to let blood move forward and close to stop blood from flowing backward.
The four valves in your heart are:
- Tricuspid valve: Between the right atrium and right ventricle
- Pulmonary valve: Between the right ventricle and the pulmonary artery
- Mitral valve: Between the left atrium and left ventricle
- Aortic valve: Between the left ventricle and the aorta
Heart valve disease can often be treated if it becomes severe enough to cause symptoms or damage the heart. Your healthcare provider may recommend surgery or a minimally invasive procedure to repair or replace the affected valve. These treatments can restore normal heart function and help you get back to living your life.
Types of heart valve disease
Heart valve disease occurs when one or more of the heart's valves don't function properly. The most common types are stenosis, regurgitation and prolapse.
Stenosis (narrowing)
Heart valves can become stiff and narrow, making it harder for blood to flow through. This condition, called valve stenosis, prevents the valve from opening fully and limits blood flow. In severe cases, the valve opening may become so small that the body doesn’t get enough blood.
- Pulmonary valve stenosis: A narrowed pulmonary valve restricts blood flow from the right ventricle to the lungs, making it harder for blood to pick up oxygen and increasing pressure in the heart. This is typically found in people with congenital heart conditions, which are usually present since birth.
- Mitral valve stenosis: A narrowed mitral valve limits blood flow from the left atrium to the left ventricle, leading to fatigue, shortness of breath and fluid buildup in the lungs. This usually occurs when young people have had a history of rheumatic fever or in older people with severe calcification.
- Aortic valve stenosis: A narrowed aortic valve restricts blood flow from the heart to the body, causing the left ventricle to work harder and eventually weaken.
Heart valve disease symptoms
Heart valve diseases tend to share symptoms, regardless of which valve is affected. Those symptoms include:
- Angina (chest pain)
- Arrhythmia/Palpitations (irregular heartbeat)
- Dizziness
- Fatigue
- Fainting
- Lightheadedness
- Shortness of breath and other breathing difficulties with exertion or with lying flat on your back
- Swelling in your ankles, belly or feet
For many people, these symptoms develop over time. Some people may not develop symptoms at all.
What causes heart valve disease?
Valve problems can happen for different reasons. Some people are born with them (congenital), while others develop them as they age or because of another health condition.
Some people are born with valve conditions like bicuspid aortic valve disease (two leaflets instead of three) or Marfan syndrome, which affects connective tissue and leads to valve issues. Acquired causes include chest radiation therapy and age-related wear and tear, which can narrow or weaken valves.
Some forms of the disease can develop after you have a medical condition, such as:
- Infective endocarditis, a bacterial infection in the lining of the heart
- Lupus, rheumatoid arthritis, mixed connective tissue disorder and other autoimmune diseases
- Radiation therapy to the chest
- Rheumatic fever, caused by scarring from untreated strep throat
What are the complications of heart valve disease?
Addressing heart valve disease can help protect your health in the long term. When your heart valves don’t function well, your heart experiences additional stress and in rare cases, blood clots. Left untreated, heart valve problems can increase your risk for:
- Heart rhythm abnormalities (atrial fibrillation)
- Congestive heart failure
- Stroke
Diagnosing heart valve disease
To diagnose heart valve disease, your provider will ask you about your medical history, carry out a physical exam and may order diagnostic tests.
Medical history and physical exam
Your provider will listen to your heart to see if you have a heart murmur or an irregular heartbeat. If one or both exist, your provider will want you to have additional diagnostic tests.
Your doctor will talk with you about your symptoms, any heart valve conditions that may run in your family and factors that could increase your risk.
During the physical exam, your doctor may check for:
- Fluid in your lungs: This could indicate your heart isn’t pumping effectively.
- An enlarged heart: This may happen if your heart is working harder than normal.
- A heart murmur: This sound could mean blood is flowing through a valve that is too narrow or not closing properly.
- Swelling in your ankles: This can be a sign of fluid buildup caused by your heart not working as well as it should.
What is the treatment for heart valve disease?
Damage to a heart valve cannot be reversed, surgical procedures may be considered to help repair or replace the damaged area.
Your doctor will work with you to identify a care plan and treatment options that best suit your condition, based on your health goals and other underlying health factors that need to be considered.
Medications
Most valve conditions can't be treated with medication alone. However, if the condition isn't severe enough to need surgery but still causes bothersome symptoms or risks, medication may help manage it for a while.
Medications may be prescribed to:
- Ease uncomfortable symptoms of milder valve problems. Diuretics can reduce excess fluid in your body, decreasing the amount of blood the heart has to pump. This lowers your blood pressure and improves your volume status.
- Help maintain a steady heart rhythm if an arrhythmia (irregular heartbeat) is present
- Reduce the risk of blood clots and stroke
Recovering from heart valve disease
You may benefit from cardiac rehab, a medically supervised exercise program designed to help you recover from your procedure. You’ll learn healthy lifestyle habits and stress management techniques with additional guidance on medications to help your heart recover and stay as healthy as possible.
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