Valvular Heart Disease

Valvular Heart Disease

There are 4 valves present in heart, they are Mitral valve, tricuspid valve, arotic vale and pulmonary valve.

There are two types of valvular heart diseases:

  1. Stenosis:- when the valve does not open fully. This restricts blood flow.
  2. Regurgitation:- Regurgitation is a disorder in which the valve does not close properly, causing blood to flow backward.

Accordingly there are 8 types of valvular heart disease like:-

  1. Mitral stenosis
  2. Mital Regurgitation
  3. Aortic Stenosis
  4. Aortic regurgitation
  5. Tricuspid stenosis
  6. Tricuspid regurgitation
  7. Pulmonary stenosis
  8. Pulmonary regurgitation

Causes of Heart Diseases:-

Valvular disease can develop before birth (congenital) or can be acquired sometime during one’s lifetime. Sometimes the cause of valve disease is unknown.

  1. Congenital Heart Disease:-

Most often affects are aortic or pulmonary valve. Valves may have developed wrong size, have malformed leaflets, or have leaflets that are not attached to the annulus correctly.

Bicuspid aortic valve disease is a congenital valve disease that affects the aortic valve. Instead of the normal three leaflets or cusps, the bicuspid aortic valve has only two. Without the third leaflet, the valve may be stiff (unable to open or close properly) or leaky (not able to close tightly).

  1. Acquired valve disease:

This includes problems that develop with valves that were once normal. These may involve changes in the structure or your valve due to a variety of diseases or infections.

  1. RHEUMATIC FEVER is caused by an untreated bacterial infection (usually strep. throat). The initial infection usually occurs in children, but the heart problems associated with the infection may not be seen until 20-40 years later. At that time, the heart valves become inflamed, the leaflets stick together and become scarred, rigid, thickened and shortened. This leads to mitral valve regurgitation.
  2. ENDOCARDITIS occurs when germs, especially bacteria, enter the bloodstream and attack the heart valves, causing growths and holes in the valves and scarring. This can lead to leaky valves. The germs that cause endocarditis enter the blood during dental procedures, surgery, IV drug use, or with severe infections. People with valve disease are at increased risk for developing this life-threatening infection.
  3. MITRAL VALVE PROLAPSE is a very common condition, affecting 1 to 2 percent of the population. MVP causes the leaflets of the mitral valve to flop back into the left atrium during the heart’s contraction. MVP also causes the tissues of the valve to become abnormal and stretchy, causing the valve to leak. The condition rarely causes symptoms and usually doesn’t require treatment.
  4. Other Conditions like Coronary artery disease, heart attack, cardiomyopathy (Heart Muscle Disease), syphilis, hypertension and arotic aneurysms.

Sign & Symptoms of Valvular Heart Diseases:-

  1. Difficulty catching your breath / Shortness of Breath. You may notice this most when you are active (doing your normal daily activities) or when you lie down flat in bed.
  2. Weakness / tiredness: You may feel too weak to carry out your normal daily activities. Dizziness can also occur, and in some cases, passing out may be a symptom.
  3. Discomfort in your chest. You may feel a pressure or weight in your chest while doing some activity or when going out in cold air.
  4. Palpitation: You may feel like a rapid heart rate, irregular heartbeat, skipped beats or a flip-flop feeling in your chest.
  5. Swelling of your ankles, feet or abdomen. Swelling may occur in your belly, which may cause you to feel bloated.
  6. A weight gain of two or three pounds in one day is possible.

Symptoms do not always relate to the seriousness of your valve disease. You may have no symptoms at all and have severe valve disease, requiring prompt treatment. Or, as with mitral valve prolapse, you may have severe symptoms, yet tests may show your valve leak is not significant.

Investigation to Diagnose Valvular Heart Diseases:-

Your Cardiologist ask details about you valve disease and its symptoms and by performing a physical exam, and may ask you to do some test like below

  1. Electrocardiography (ECG)
  2. Trans-esophageal Electrocardiography
  3. Cardiac Catheterization
  4. Chest X-ray
  5. Doppler Ultrasound
  6. 2D Echocardiography
  7. MRI of the heart

Treatment & Management of Valvular Heart Diseases:-

Treatment for heart valve disease depends on the type and severity of valve disease. There are three goals of treatment for heart valve disease:

  • Protecting your valve from further damage;
  • lessening symptoms;
  • and repairing or replacing valves.
  • Protecting your valve from further damage.

If you have valve disease, you are at risk for developing endocarditis, a serious condition. People who have mitral valve prolapse without thickening or regurgitation / leaking are not at risk of developing endocarditis.

You are still at risk for endocarditis, even if your valve is repaired or replaced through surgery. To protect yourself:

  • Tell your doctors and dentist you have valve disease.
  • Consult a doctor if you have fever and sore throat.
  • Take care of teeth and gums to prevent infections.
  • Take antibiotics whenever you have infection or surgical procedures.

Medications. You may be prescribed medications to treat your symptoms and to lessen the chance of further valve damage. Medications should be taken as per doctors advice. Medicine which are ad viced are diuretics, anti-arrhythmic drug, vasodialator, ACE inhibitors, beta-blockers, anti-coagulants

Surgery and Other Procedures.

Surgical options include heart valve repair or replacement. Valves can be repaired or replaced with traditional heart valve surgery or a minimally invasive heart valve surgical procedure. Heart valves may also be repaired by other procedures such as per cutaneous balloon valvotomy. Cardiologist specialist would be best doctor to advice what type of treatment will work best for you.