VALVE DISEASE

What is heart valve disease?

Heart valve disorders can arise from two main types of problems:

• Regurgitation (or leakage of the valve). When the valve doesn’t close completely, it causes blood to flow backward through the valve. This reduces forward blood flow and can lead to volume overload in the heart.

• Stenosis (or narrowing of the valve). When the valve opening becomes narrowed, it limits the flow of blood out of the ventricles or atria. The heart is forced to pump blood with increased force to move blood through the narrowed or stiff valve.

Heart valves can develop both regurgitation and stenosis at the same time. Also, more than one heart valve can be affected at the same time. When heart valves fail to open and close properly, the effects on the heart can be serious, possibly hampering the heart's ability to pump enough blood through the body. Heart valve problems are one cause of heart failure.

Symptoms of heart valve disease

Mild to moderate heart valve disease may not cause any symptoms. These are the most common symptoms of heart valve disease:

• Chest pain
• Palpitations caused by irregular heartbeats
• Fatigue
• Dizziness
• Low or high blood pressure, depending on which valve disease is present
• Shortness of breath
• Abdominal pain due to an enlarged liver (if there is tricuspid valve malfunction)
• Leg swelling

Symptoms of heart valve disease may look like other medical problems. Always see your doctor for a diagnosis.

Causes of heart valve damage

The causes of heart valve damage vary depending on the type of disease present, and may include the following:

• Changes in the heart valve structure due to aging
• Coronary artery disease and heart attack
• Heart valve infection
• Birth defect
• Syphilis (a sexually transmitted infection)
• Myxomatous degeneration (an inherited connective tissue disorder that weakens the heart valve tissue)

The mitral and aortic valves are often most affected by heart valve disease. Some of the more common heart valve diseases include:

• Bicuspid aortic valve: With this birth defect, the aortic valve has only two leaflets instead of three. If the valve becomes narrowed, it’s harder for the blood to flow through, and often the blood leaks backward. Symptoms usually don't appear until the adult years.
   
• Mitral valve prolapse (also known as click-murmur syndrome, Barlow's syndrome, balloon mitral valve or floppy valve syndrome): With this defect, the mitral valve leaflets bulge and don't close properly during the contraction of the heart. This lets blood leak backward. This may result in a mitral regurgitation murmur.
   
• Mitral valve stenosis: With this valve disease, the mitral valve opening is narrowed. It’s often caused by a past history of rheumatic fever. It increases resistance to blood flow from the left atrium to the left ventricle.
   
• Aortic valve stenosis: This valve disease occurs mainly in the elderly. It causes the aortic valve opening to narrow. This increases resistance to blood flow from the left ventricle to the aorta.
   
• Pulmonary stenosis: With this valve disease, the pulmonary valve doesn’t open sufficiently. This forces the right ventricle to pump harder and enlarge. This is usually a congenital condition.

Treatment for heart valve disease

In some cases, your doctor may just want to closely watch the heart valve problem for a period of time. However, other options include medications or surgery to repair or replace the valve. Treatment may include:

• Medications: Medicines, such as beta blockers and diuretics, are not a cure for heart valve disease, but can often relieve symptoms.

• Surgery: Surgery may be needed to repair or replace the malfunctioning valve(s).

• Non-surgical Treatments: These could include Transcatheter Aortic Valve Replacement or Transcatheter Mitral Valve Repair.