Understanding Valvular Heart Disease
Dr. Angel Rivera
Valvular heart disease is a condition where one (or more) valves in the heart is not working properly. It’s a condition that affects primarily older adults and about 2.5 % of the population, according to the Centers for Disease Control and Prevention (CDC). We’ll answer your questions on valvular heart disease, such as what it is and how valvular heart disease affects your health. We’ll provide you with information about how to prevent valvular heart disease so you can have an informed discussion with your healthcare provider.
What are heart valves and how do they function?
The human heart has four valves that control the flow of blood from one part of your heart to another and also from your heart to the rest of your body.
- mitral valve between the left atrium and left ventricle
- aortic valve between the left ventricle and aorta
- pulmonary valve between the right ventricle and pulmonary artery
- tricuspid valve between the right atrium and right ventricle
These valves are important because they prevent the backflow of your blood from going to places where it doesn't belong. Valves can become narrowed or even jammed completely closed for different reasons, which is when valvular heart disease can occur. Any of these valves may get heart valve disease but the aortic valves are the most common.
What is heart valve disease?
Valvular heart disease is a broad term that encompasses many different types of valvular disorders. Valves are important because they regulate the flow of blood through your heart, giving it the right pressure and direction. The three main types of valvular heart disease are valvular stenosis, regurgitation, and prolapse. Valvulitis, or inflammation of the lining on the inside surface of your heart's chambers, can be caused by infection, autoimmune diseases like rheumatoid arthritis or lupus, or endocarditis. Rheumatic heart disease can also occur from rheumatic fever.
Heart valve stenosis is the most common valvular heart disease. When a valve becomes narrowed or even jammed completely closed and blood can not pass, this condition is known as stenosis.
Valve stenosis can be caused by a number of things including infection, autoimmune diseases, or endocarditis. Aortic stenosis is one of the most common types of stenosis.
Heart valve regurgitation occurs when blood flows backward from one area to another through a leaky valve. This means that not all of your blood is able to go where it needs to because some leaks back into an earlier stage in circulation. Regurgitation can be caused by infection, a heart attack, endocarditis, and other reasons.
Mitral valve prolapse occurs when the flaps in the mitral valve bulge. Sometimes blood leaks back into the chamber caused by mitral valve regurgitation. Many people don’t have symptoms when they are diagnosed with mitral valve prolapse and don’t require treatment.
What causes valvular heart disease?
Valvular heart disease is a condition in which the valves that control blood flow to and from the lungs are damaged. It can be caused by infections, congenital conditions, age, and other types of heart disease conditions.
Some of the causes of heart valve damages may include:
- changes in the heart valve structure from aging
- coronary artery disease, caused by plaque buildup on the walls of the arteries
- heart attack
- birth defect
- syphilis, a sexually transmitted disease
- myxomatous degeneration, an inherited connective tissue disorder
If you're not sure if you have valvular heart disease, talk to your doctor about getting tested for these conditions today. Your doctor may also recommend treatment options for each case depending on what's causing it.
What are the symptoms of valvular heart disease?
Symptoms will vary depending on what type of valvular heart disease you have. Some of the most common symptoms, according to the American Heart Association are:
- chest pain or palpitations, palpitations meaning the heart is beating fast or skipping
- shortness of breath or difficulty catching your breath
- unable to maintain a normal activity level
- swollen abdomen, feet, or ankles
Should you experience any of these conditions please seek medical attention immediately.
How do you diagnose valvular heart disease?
There are several different methods and heart tests doctors may employ to determine if you are having heart valve problems. Doctors typically use an EKG, or the electrocardiography test to determine if your heart valve has become narrowed or clogged due to inflammation. This condition can be diagnosed by checking for many different issues including:
- quality of blood circulation in certain parts of the body such as lungs, arm veins, or legs
- frequent headaches
- excessive fatigue
- recurrent coughs or cold-like symptoms
- significant weight loss without dieting
Doctors may also recommend a chest X-ray to check for valvular stenosis in the lungs or valvular regurgitation of the heart's blood vessels which will cause pooling of blood at different levels within the organ. To diagnose valvular prolapse, an echocardiographic examination is usually done by checking abnormalities in valve function and location, as well as any other inner structures that affect it such as your heart muscle and thickness of the walls of the valve.
Angiograms, echocardiograms which use sound waves for an ultrasound of your heart, stress tests, and heart MRIs are other methods your doctor may use to help diagnose valvular heart disease.
How do you treat valvular heart disease?
Heart valve disease treatment has many options to repair the valves. These include:
- balloon valvuloplasty
- valve repair by sewing a patch to stop leakage
- implantation of an artificial cardiac valve replacement device such as a plastic valve made from animal pericardium tissue, called bioprosthetic
- human synthetic material that will open correctly with expansion but close after contraction
- insertion of devices called stents into narrowed valves in order to keep them open permanently until scar tissue can grow around them so they won't need long-term support anymore
Treatment options also generally involve medication therapy including blood pressure medications which are used both before and after surgical procedures because high blood pressure can weaken heart valves.
The valvular annulus is the ring around a valve that attaches to the heart wall and keeps it in place while contracting. It may need to be repaired with surgery if scar tissue has built up over time and narrowed the opening so much that blood flow becomes too narrow for adequate circulation of oxygenated blood during a contraction when valvular stenosis occurs.
One of the most common treatments is valve replacement surgery or the insertion of a mechanical heart valve that will open and close with contraction in order to prevent backflow during ventricular contractions. Other options might include implantation of an artificial cardiac pacemaker device which would synchronize contractions so both chambers are emptying at the same time. This does not change how well the valves themselves are working but it can help restore regularity to normal blood flow within individual heart chambers by making sure they empty out each cycle instead of only one chamber doing all the work.
Depending on what type it is there are many ways to treat each condition but most importantly you should be aware of what valvular heart disease is. Ask your doctor about the best course of treatment for you and always make sure to take care of yourself.
Can I prevent valvular heart disease?
Although valvular heart disease can not always be prevented, for instance, congenital problems with a birth defect, there are ways to maintain a healthy lifestyle to lower your risk of getting the condition. If you are a patient with diabetes, you should always be sure to monitor and maintain your diabetes to help prevent heart valve disease. Monitoring and controlling your blood pressure and blood cholesterol is a good start, but here is an easy guideline to help prevent your heart valves from disease.
- Don't smoke. If you do smoke, then quit.
- Maintain an active lifestyle and healthy weight.
- Eat healthy.
- Don't overindulge in alcohol.
- Manage stress.
Making these healthy lifestyle changes does not guarantee that you will not get valvular heart disease, but it may decrease your chances of getting it. Talk to your doctor or healthcare provider to discuss lifestyle changes that can be beneficial to your heart.
There are many ways to treat valvular heart disease and it is important that you are aware of what type of valvular heart disease you have in order to receive better treatment options. Surgery, taking medications, and even balloon valvuloplasty are all options for treating this condition. There are also ways to prevent it, too, by living a healthy lifestyle, although not all forms are preventable. We have provided the basics of valvular heart disease. Please talk to a doctor or pharmacist should you have any more questions.
Centers for Disease Control and Prevention – Valvular Heart Disease
Johns Hopkins Medicine – Heart Valve Diseases
American Heart Association – Symptoms of Heart Valve Disease
Mayo Clinic – Valvuloplasty