Valvular heart disease

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at May 27, 2016
StartDiseasesValvular heart disease

Valvular heart disease is a broad term used to apply to any disease that affects one of the four valves of the heart. If left untreated, valvular heart disease can potentially be fatal because it may result in interrupted or halted circulation of the blood. It is also referred to as heart valve disease.

Contents

Definition & Facts

Valvular heart disease occurs when there is a damage or defect in the mitral valve, tricuspid valve, pulmonary valve, or aortic valve. Typically, valves affected by this condition are unable to open or shut completely, harming blood flow. The most common types of valvular heart disease are mitral valve stenosis or aortic valve stenosis, which happen when either valve cannot open fully, and mitral valve regurgitation or aortic valve regurgitation, which happen when either valve cannot close correctly.

Though the left valves of the heart, called the aortic and mitral valves, are most likely to be affected, valvular heart disease can also occur on the right. However, pulmonary valve diseases are rather rare. Most people diagnosed with valvular heart disease are over the age of 55, and by the time they reach 75, one in ten seniors have this condition.

Symptoms & Complaints

The symptoms of valvular heart disease can develop slowly, or they can occur suddenly. A small valve leak may cause excessive symptoms, while a severe case of valvular heart disease can sometimes occur with almost no symptoms at all. For most people with valvular heart disease, the symptoms are general symptoms of congestive heart failure that occur when the heart cannot function properly.

People with this condition often feel short of breath and begin to wheeze even after extremely mild exercise. Valvular heart disease can often cause feelings of fatigue, exhaustion, and fainting. As the heart struggles to maintain a proper rhythm, a person might experience heart palpitations and chest pain, which can range from mild to severe.

Since the blood cannot properly circulate through the body, the hands, feet, and ankles can start to swell from fluid buildup. Symptoms of untreated valvular heart disease are very severe, and they include heart failure, blood clots, stroke, and cardiac arrest.  

Causes

There are many different causes of valvular heart disease. Regurgitation typically happens when valves become prolapsed, causing them to bulge or flop around during a heartbeat, letting blood leak back into chambers instead of flowing outward. Stenosis normally happens when valves become thickened or fused together, preventing them from opening completely during a the cardiac cycle.

In some cases, the condition is congenital, which means that a person was born with an abnormal heart valve, and this often happens if the heart does not form properly while the fetus is in the womb. Many women experience it during pregnancy, because pregnancy requires a 50 percent increase in blood volume, which can cause high blood pressure and increase the risk of other conditions that contribute to valvular heart disease.

Valvular heart disease can also be caused by infection or disease, such as bacterial infections, rheumatic fever, autoimmune disease, or cancer. In these cases, the medical condition causes inflammation that harms the heart. All of the aforementioned causes can affect a person at any stage of life, but the biggest cause of valvular heart disease is aging. As people get older, the heart begins to wear out, and eventually it can develop problems.

Diagnosis & Tests

The first step in diagnosis is typically a physical examination that includes the doctor listening to a patient's heartbeat for any irregularities. If a heart murmur or other abnormality is detected, the valvular condition can be diagnosed in a few different ways.

Using sound waves, an echocardiogram can create a picture of the heart, showing any valves that are misshapen or not working correctly. Echocardiograms are one of the most commonly used tests for diagnosing valvular heart disease, because they show the shape of the heart and the current of the blood flow through the heart. An electrocardiogram can measure the regularity of heartbeats and the electrical actions of the heart.

Cardiac catheterization can also be used to measure the pressure of valves by threading a catheter through the valves. All of these tests can be used to discover and diagnose a malfunctioning heart valve. Another common test for valvular heart disease is a cardiac stress test that requires a patient to run on a treadmill while heart rate, blood pressure, and breathing is monitored.

Treatment & Therapy

Though there is no way to cure valvular heart disease with medication or therapy, a severely damaged or malfunctioning heart valve can be repaired or replaced with surgery. Surgery is a common treatment option for people who are younger or otherwise in good health, but it can be dangerous for weakened, elderly patients. If a person has a heart defect without any severe symptoms, lifestyle changes and medication can be used to prevent the condition from worsening.

Anti-arrhythmic medicine can keep the heart from beating irregularly, while vasodilators make it easier for the heart to pump blood. Both beta blockers to lower blood pressure and anticoagulants to thin the blood may be prescribed to decrease the risk of heart attacks or strokes. Diuretics are used to treat the edema that often happens with valvular heart disease. Staying at a healthy weight, eating a high fiber diet, and avoiding tobacco, excessive quantities of sodium, or alcohol can all help to prevent the condition from worsening.

Prevention & Prophylaxis

Though lifestyle changes will not prevent valvular heart disease, they can help lessen a person's chances of developing the disease. Therefore eating healthy, regularly exercising, quitting smoking, and treating high blood pressure with high blood pressure medications may all help to keep the heart valves healthy.

Prompt treatment of rheumatic fever and other conditions that cause heart disease can prevent damage to the heart valves. Maintaining good oral hygiene has also been linked to a slightly decreased risk of heart diseases.