Valvular Heart

What is Valvular Heart Disease?
Valvular heart disease is characterized by damage to or a defect in one of the four heart valves: the mitral, aortic, tricuspid or pulmonary. The mitral and tricuspid valves control the flow of blood between the atria and the ventricles (the upper and lower chambers of the heart). The pulmonary valve controls the flow of blood from the heart to the lungs, and the aortic valve governs blood flow between the heart and the aorta, and thereby the blood vessels to the rest of the body. The mitral and aortic valves are the ones most frequently affected by valvular heart disease.

Normally functioning valves ensure that blood flows with proper force in the proper direction at the proper time. In valvular heart disease, the valves become too narrow and hardened (stenotic) to open fully, or are unable to close completely (incompetent).

A stenotic valve forces blood to back up in the adjacent heart chamber. While an incompetent valve allows blood to leak back into the chamber it previously exited. To compensate for poor pumping action, the heart muscle enlarges and thickens, thereby losing elasticity and efficiency. In addition, in some cases, blood pooling in the chambers of the heart has a greater tendency to clot, increasing the risk of stroke or pulmonary embolism.

The severity of valvular heart disease varies. In mild cases there may be no symptoms, while in advanced cases, valvular heart disease may lead to congestive heart failure and other complications. Treatment depends upon the extent of the disease.

When to Call an Ambulance?
Call an ambulance if you experience severe chest pain.


When to Call Your Doctor?
Call your physician if you develop persistent shortness of breath, palpitations or dizziness.

What are the symptoms?
Valve disease symptoms can occur suddenly, depending upon how quickly the disease develops. If it advances slowly, then your heart may adjust and you may not notice the onset of any symptoms easily. Additionally, the severity of the symptoms does not necessarily correlate to the severity of the valve disease. That is, you could have no symptoms at all, but have severe valve disease. Conversely, severe symptoms could arise from even a small valve leak.
Many of the symptoms are similar to those associated with congestive heart failure, such as shortness of breath and wheezing after limited physical exertion and swelling of the feet, ankles, hands or abdomen (edema). Other symptoms include:
Palpitations, chest pain (may be mild)
Fatigue
Dizziness or fainting (with aortic stenosis)
Fever (with bacterial endocarditis)
Rapid weight gain

What are the causes?
There are many different types of valve disease; some types can be present at birth (congenital), while others may be acquired later in life.

Heart valve tissue may degenerate with age.
Rheumatic fever may cause valvular heart disease.
Bacterial endocarditis, an infection of the inner lining of the heart muscle and heart valves (endocardium), is a cause of valvular heart disease.
High blood pressure and atherosclerosis may damage the aortic valve.
A heart attack may damage the muscles that control the heart valves.
Other disorders such as carcinoid tumors, rheumatoid arthritis, systemic lupus erythematosus, or syphilis may damage one or more heart valves.
Methysergide, a medication used to treat migraine headaches, and some diet drugs may promote valvular heart disease.
Radiation therapy (used to treat cancer) may be associated with valvular heart disease.


What are the prevention steps?
Get prompt treatment for a sore throat that lasts longer than 48 hours, especially if accompanied by a fever. Timely administration of antibiotics may prevent the development of rheumatic fever which can cause valvular heart disease. A heart-healthy lifestyle is also advised to reduce the risks of high blood pressure, atherosclerosis and heart attack.
Don’t smoke.
Consume no more than two alcoholic beverages a day.
Eat a healthy, balanced diet low in salt and fat, exercise regularly and lose weight if you are overweight.
Adhere to a prescribed treatment program for other forms of heart disease.
If you are diabetic, maintain careful control of your blood sugar.