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By Lawrence Reaves
The heart has four valves that control the flow of blood from the upper chambers (atria) to the lower chambers (ventricles), and outward from the ventricles. The tricuspid valve is located between the right atrium and right ventricle; the pulmonary valve is found between the right ventricle and pulmonary trunk; the mitral valve sits between the left-sided chambers; and the aortic valve allows blood to flow out of the left ventricle to the aorta.
Under normal circumstances, these valves open and close tightly as the heart’s chambers expand and contract. Blood is allowed to move forward – from the atria to the ventricles, and from the ventricles to their corresponding arteries – and prevented from flowing backward. When the valves fail to work as expected, the condition is called heart valve disease (HVD).
Most valvular problems can be categorized as stenosis (failure to open properly) or regurgitation (failure to close properly). We’ll explain the issues that result from both circumstances below. We’ll also briefly describe the various types of HVD as well as how they are corrected.
Possible Causes Of Heart Valve Problems
There are several factors that can contribute to valvular stenosis or regurgitation. In some cases, HVD is a congenital condition (the valves are diseased at birth). Other times, it is due to age; older people are more susceptible to valvular issues since they are more likely to have calcium deposits on the valves. Still other times, HVD is acquired.
For example, a patient who suffers from high blood pressure, or has experienced a severe heart attack in the past, may have damaged valves. Plaque accumulation in the aorta can also contribute to HVD. If a person suffers from strep throat and does not have access to the necessary antibiotics, the bacterial infection may evolve into rheumatic fever. The body’s autoimmune response can inflame and damage the valves. Complications arising from lupus, endocarditis, and radiation therapy for treating cancer are also among possible contributing factors.
Presentation And Naming Of Heart Valve Disease Types
Each of the heart’s four valves can display stenosis or regurgitation (and in rare cases, atresia, which is defined by an absent opening). While such problems are referred to with the general term “heart valve disease,” doctors typically refer to the specific valve and issue. For example, when the mitral valve is stenotic, it is called “mitral valve stenosis.” Likewise, a regurgitant pulmonary valve may be called “pulmonary valve regurgitation.”
Side Effects Caused By Valvular Heart Disease
The first indication of HVD is usually a heart murmur. This is an unusual sound that can be heard through a stethoscope. Murmurs are not dangerous, but often reflect other heart problems. Because heart valve disease tends to worsen with time, a patient who displays a murmur while young may not develop symptoms until many years later. Symptoms typically include fatigue, shortness of breath, and edema (swelling due to fluid buildup) in the feet or ankles.
Patients may also develop arrhythmias as the heart’s normal rhythm is disrupted by the diseased valve. Heart palpitations are also common as the condition worsens. This can cause blood clots to develop in the atria and ventricles. With time, HVD can lead to pulmonary hypertension and heart failure.
How Valve-Related Problems Are Corrected
Medications can be given to help reduce the patient’s symptoms. For example, beta blockers are useful for lowering high blood pressure and slowing the heart’s rhythm. But drugs alone cannot cure the disease. A doctor may recommend a procedure known as balloon valvuloplasty to address a stenotic valve. A catheter is fitted with a small balloon on its tip, and inserted into a vein. The physician will direct the catheter to the diseased valve, and inflate the balloon to expand the opening.
If balloon valvuloplasty cannot be used to correct HVD – as is the case with regurgitation – surgery must be performed. Minimally-invasive surgical repair may be possible depending on the circumstances. However, many cases of severe valvular heart disease require that the diseased valve is replaced, a procedure that usually requires invasive open heart surgery.
Newer, less-invasive surgical techniques are currently being used in place of open heart surgery in specific cases of HVD. Ask your physician for more information regarding available treatment options.
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