All You Need to Know About Heart Valve Disease

The heart has four chambers: two lower chambers (ventricles) and two upper chambers (atria). Blood travels through a valve as it exits each section of the heart.

Valves prevent the backflow of blood. They act as one-way blood inflows on one side of a ventricle and one-way blood outflows on the other. The four heart valves include the following:

TRICUSPID VALVE: Situated between the right atrium and right ventricle.

PULMONARY VALVE: Situated between the right ventricle and the pulmonary artery.

MITRAL VALVE: Situated between the left atrium and the left ventricle.

AORTIC VALVE: Situated between the left ventricle and the aorta.

FUNCTIONING OF HEART VALVES

The valves open and close as the heart muscle contracts and relaxes, allowing blood to flow inside the ventricles and off to the rest of the body at alternating times.

Next, we will show you a step-by-step explanation of the blood flow through the heart.

The left and right atria contract once they fill with blood, opening the mitral and tricuspid valves and then pumping blood into the ventricles.

The left and right ventricles come into contact, closing the mitral and tricuspid valves and preventing the backflow of blood. Simultaneously, the aortic and pulmonary valves open to allow blood to pump out of the heart.

The left and right ventricles relax – first, the aortic and pulmonary valves close, preventing blood from flowing backward into the heart. Then, the mitral and tricuspid valves open to allow forward blood flow into the heart to fill the ventricles again.

HEART VALVE DISEASES

There are different kinds of heart valve disease, and more than one valve may be affected. The types of heart valve diseases include the following:

–VALVULAR STENOSIS OR NARROWING OF THE VALVE

With valvular stenosis, the tissues that form the valve leaflets become stiffer, which narrows the valve opening and reduces the amount of blood that can flow through the valve. Mild narrowing may not reduce the overall function of your heart.

However, the valve can become so narrowed (stenosis) that it reduces the function of your heart, causes your heart to pump harder, and puts it under stress. Therefore, the rest of your body may not get sufficient flow.

–VALVE REGURGITATION OR INSUFFICIENCY

Valve regurgitation (leaky valve, incompetence, insufficiency) occurs when the leaflets do not close completely, allowing blood to leak backward through the valve.

The heart must pump harder to compensate for backward or regurgitant flow, and the rest of the body may receive less blood flow.

When you have mitral valve prolapse, you may experience reflux, a common problem in which the valve flaps back up into the left atrium when the heart beats.

–VALVE ATRESIA

Valvular atresia occurs when a heart valve does not form correctly before birth. Usually, physicians diagnose this condition very early in infancy.

HEART VALVE DISEASE SYMPTOMS

About 2.5 percent of Americans (many older adults) have heart valve disease. Approximately twenty-eight thousand people die annually from heart valve disease in the United States. In addition, mitral valve damage or deterioration is a frequent heart valve problem.

When a heart valve does not work correctly, it puts pressure on your heart because it must work harder. It can also cause less blood flow to your body.

It is common for individuals with heart valve disease to have no symptoms. But when the heart valve problem worsens, your heart beats harder to compensate for the reduced blood flow. Over time, heart valve disease can get bad enough that the following symptoms begin to appear:

• Palpitations (skipped beats or a flip-flop sensation in the chest)
• Increased shortness of breath, especially with physical activity or lying down.
• Weakness or dizziness
• Edema (swelling of the abdomen, feet, or ankles)
• Chest discomfort, especially when straining
• Rapid weight gain
• Fatigue
• If an infection causes valve disease, you may notice fever, body aches, or chills.

HEART VALVE DISEASE CAUSES

Frequent causes of heart valve disease include the following:

• A heart attack that damages your heart
• Rheumatic fever from strep throat that went untreated
• A congenital problem that has been present since birth, such as an aortic or pulmonary valve that did not develop properly
• High blood pressure (advanced)
• Thoracic aortic aneurysm (dilatation of the aorta, which stretches the aortic valve leaflets and may cause leakage)
• Calcification or degeneration of valve tissue, with loss of function over time
• Heart failure
• Infective endocarditis (infection in your heart)

TESTS FOR DIAGNOSING HEART VALVE DISEASE

When healthcare providers or physicians perform a physical exam and listen to your heart through a stethoscope, they may find the following signs of heart valve disease:

• An enlarged heart
• Fluid in your lungs
• Swelling in the ankles
• A heart murmur, which could mean that blood is moving through a stenotic or leaky valve

Various medical studies and tests can also show heart valve disease. Repeating exams over time can help healthcare providers or physicians see how your valve disease is progressing and make decisions about your treatment.

Tests for the diagnosis of heart valve disease include the following:

• ECHOCARDIOGRAM

A heart ultrasound, or echocardiogram, is a moving picture of the valves and chambers of your heart using sound waves from a hand-held wand placed on your chest.

• TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE)

The transesophageal echocardiogram is an ultrasound of the heart which the provider performs by inserting a probe with an ultrasound transducer into the esophagus. This test can provide more precise and clear images than a normal echocardiogram because the esophagus is close to the heart.

• EXERCISE STRESS ECHOCARDIOGRAM

A provider performs an echocardiogram after you walk on a treadmill or ride a bicycle to see how the valves and heart function respond to exercise.

• CHEST X-RAY

A chest x-ray is a quick x-ray of your chest.

• CARDIAC CATHETERIZATION

A cardiac catheterization or angiography is an x-ray film of the coronary arteries, heart chambers, and valves. An injection of contrast dye into a catheter in your arm or leg helps produce the images.

• ELECTROCARDIOGRAM (ECG or EKG)

Your provider attaches small electrode patches to the skin to obtain the information and record the heart’s electrical activity on graph paper.

• MAGNETIC RESONANCE IMAGING (MRI)

Magnetic resonance imaging is when radio waves and a magnet work together to create high-quality images of your heart.

HEART VALVE DISEASE TREATMENTS

A heart valve problem may be severe if left untreated. Although you cannot undo the damage to a heart valve, you can treat the difficulty.

Treatments for heart valve disease depend on the underlying cause and may include the following:

• Taking medications
• Protecting your valve from further damage
• Seeing your cardiologist for periodic visits
• Undergoing invasive procedures or surgery if necessary

The decision to prescribe medical treatment, surgical replacement, or repair depends on several factors, including the following:

• The severity of the damage
• The type of valve disease
• Your medical history
• Your age

If you are pregnant and have heart valve disease, you may be able to get extra rest and take certain medications that are secure for your baby.

If you are aware of your valve disease before pregnancy, ask your healthcare provider if you require tests or a visit to a cardiologist before getting pregnant to ensure that you receive appropriate care before and during pregnancy.

In addition, if you have a severe valve problem, your physician may recommend valve repair or replacement before pregnancy.

SURGICAL REPLACEMENT OR REPAIR

Heart valve disease is a mechanical disruption when the leaflets open or close, so you may eventually require surgery to replace or repair your valve. Also, some infants and children born with valve problems require surgery during infancy.

Usually, the surgeon and cardiologist will know the best treatment before surgery. Other times, the surgeon makes that decision when seeing your valve during surgery.

The advantages of valve repair are the following:

• The reduced risk of infection
• A decreased need for lifelong anticoagulant medications
• The preservation of heart muscle function and strength.

Surgeons have to replace valves they cannot repair. So, these replacement valves can provide adequate function when the repair cannot. However, depending on the valve your healthcare provider uses, you may need to take certain medications to prevent blood clots or have a new valve replaced in ten to fifteen years.

EMERGENCY WARNINGS

You must call 911 if you experience the following symptoms after a heart valve surgery:

• Chills or fever
• Fainting
• Chest pain
• Feeling stomach-sick, vomiting, or having diarrhea
• Heart rate of more than one hundred and fifty beats per minute
• Shortness of breath that does not improve with rest
• Severe headache, numbness, or weakness of legs or arms without warning
• Stools with bright red blood or dark black stools
• Bright red blood when coughing

Even though heart valve disease is lifelong, you may control it with medication or surgery. You can talk with your healthcare provider or physician about the best option for your situation. Regardless of what your physician does, you can do your part too.

You can exercise more, avoid using tobacco products, and eat heart-healthy foods. You must keep taking your prescribed medications and keep all of your follow-up appointments.

We are Modern Heart and Vascular Institute, a diagnostic and preventative medicine cardiology practice. For more information, contact us.