9 Things You Should Know About Heart Valve Disease



Your heart has four valves, which ensure one-way blood flow through the heart muscle. When you hear your heartbeat, that’s the sound of these valves opening and closing. However, when they become damaged or diseased, your health can suffer—and you may eventually need surgery. Here are the main facts you need to know.

1. There are two mains types of valve disease

A heart valve can malfunction in two key ways. Firstly, the valve may not open fully, which is called stenosis. Your heart then has to work harder to force blood through the narrowed opening. Alternatively, a valve can fail to close properly, which is called regurgitation. Your heart also has to work harder in this case, as it tries to counteract the leaking backflow of blood.

In either case, diagnosis is usually made through an echocardiogram—a painless, risk-free ultrasound procedure that provides images of the heart’s structure.

2. The causes are diverse

The main causes of heart valve disease are as follows:

• Being born with an abnormal valve
• Calcium build-up associated with aging
• Rheumatic fever (a dangerous but uncommon complication of streptococcus infections of the throat).
• Cardiomyopathy (a type of heart disease that often runs in families)
• Damage caused by a heart attack
• Endocarditis (an life-threatening infection of the heart lining)

Many of these causes cannot be prevented. However, controlling general risk factors for coronary heart disease can reduce your chances of developing thickened valves associated with stenosis. In other words, keep your weight, cholesterol and blood pressure in check. In addition, reduce rheumatic fever risk by having any suspected case of strep throat treated with antibiotics.

3. It is not always a serious health problem

One type of heart valve abnormality – mitral valve prolapse (MVP)—is incredibly common, affecting up to 2% of the population. Although this condition does involve a leaky, regurgitating valve, it seldom causes any symptoms and rarely needs treated. So, if you’re diagnosed with a standard case of mitral valve prolapse, try not to worry too much!

4. Symptoms vary

Not all cases of heart valve disease progress to the point of causing symptoms that influence daily health. In addition, even severe cases sometimes cause surprisingly few symptoms, and are only discovered when an unusual heart sound (i.e. a heart murmur) is heard at a routine appointment.

However, if you do have a moderate to severe case of heart valve disease, you may notice that you feel out of breath after any activity, your ankles and feet swell up, and you are tired all the time. Some people also report a fluttering or racing heartbeat.

5. Treatment may merely involve “watchful waiting”

If you have mild or moderate heart valve disease, your cardiologist may suggest abstraining from treatment but undergoing examinations every 12 months. It is difficult to predict when (or indeed if) heart valve disease will advance, so you may go for years or decades without hearing any significant news at your annual review.

6. It need not always limit your activities

Many people with a diagnosis of heart valve disease worry that they won’t be able to exercise, but most can continue with a normal lifestyle. However, some people will be advised to avoid heavy weightlifting, as this can put a strain on the heart that exacerbates the existing valve damage. Always ask your doctor for advice.

Thankfully, with careful monitoring, most cases of mild to moderate heart valve disease are also perfectly compatible with a healthy pregnancy.

7. It increases your risk of infectious endocarditis

Unfortunately, just as an infection of the heart lining can cause valve disease, so too does valve disease itself make you more likely to develop such an infection. Bacteria in the bloodstream are more likely to stick to an abnormal valve because of its uneven surface, so be sure to report any flu-like illness that is accompanied by a high fever.

In addition, maintain consistently good oral hygiene, as bacteria in the mouth is among the most likely to indirectly cause endocarditis.

8. Drug treatments can slow its progress

If your cardiologist thinks you need treatment due to your symptoms and the degree to which your valve damage is putting a strain on your heart, you may be offered drugs as a first option. Common examples include ACE inhibitors (which relieve the strain on your heart by relaxing blood vessels) and diuretics (which counteract fluid buildup in your extremities), which also lower blood pressure.

9. Valve replacements are advancing all the time

Finally, severe cases of heart valve disease often necessitate surgical replacement or repair. Such procedures often relieve symptoms entirely and dramatically reduce the likelihood of further heart problems. If a replacement is recommended, you may choose either a mechanical valve or a tissue valve from another animal. Both have pros and cons—for example, mechanical valves last much longer, but require lifelong use of blood-thinning medications (e.g. warfarin).

While such procedures traditionally require open-heart surgery, continuing research is making less invasive replacement (with far fewer incisions) increasingly common. Even more reassuring is the fact that some replacements can now be done through a catheter inserted into a groin artery, leading to shortened recovery times and lower risks of infection.

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