Heart Valve Diseases
Heart valve disease occurs when one or more of the heart's four valves fail to function correctly, potentially straining the heart and disrupting blood flow.
What are heart valve diseases?
The heart contains four valves: the tricuspid, pulmonary, mitral, and aortic valves. These valves feature flaps that open to allow blood flow and close between heartbeats to prevent blood from flowing backward. When these valves do not open or close correctly, it can strain the heart and affect circulation. Fortunately, most valve diseases can be treated.
Types of Heart Valve Diseases
Heart valves can experience three primary types of problems:
- Regurgitation: Backflow occurs when valve flaps do not close tightly, allowing blood to leak backward. A common cause is prolapse, where the flaps bulge back, most often affecting the mitral valve.
- Stenosis: This happens when valve flaps become thick, stiff, or stuck together, preventing the valve from opening fully and restricting blood flow. Aortic valve stenosis is a common example.
- Atresia: This occurs when a heart valve fails to form properly and lacks an opening for blood to pass through.
In some instances, a valve may suffer from both regurgitation and stenosis.
Causes and Risk Factors
Heart valve disease can be congenital (present at birth) or develop over time. Factors that increase the likelihood of developing these diseases include:
- Advanced age: Valves can naturally thicken and stiffen over time.
- Existing heart conditions: Including rheumatic fever, endocarditis, heart attack, heart failure, coronary artery disease, high blood pressure, high blood cholesterol, diabetes, obesity, and lack of physical activity.
- Family history: A history of early heart disease in parents or siblings.
- Congenital defects: Such as an improperly formed aortic valve.
Symptoms and Complications
While many people live with minor valve issues without symptoms, the condition can worsen over time. Common symptoms include:
- Shortness of breath
- Fatigue
- Swelling in the feet, ankles, abdomen, or neck veins
- Chest pain during physical activity
- Arrhythmia (irregular heartbeat)
- Dizziness or fainting
If left untreated, the increased workload on the heart can lead to heart failure, stroke, blood clots, or sudden cardiac arrest.
Diagnosis and Treatment
Diagnosis typically involves a physical exam and listening for abnormal sounds like clicks or heart murmurs. Further evaluation by a cardiologist and heart tests are usually required.
Treatment options include:
- Medicines to manage symptoms and heart function.
- Heart-healthy lifestyle changes.
- Surgery to repair or replace the valve.
Repair is generally preferred over replacement when possible. If replacement is necessary, options include biologic valves (from pig, cow, or human tissue) or mechanical valves (human-made), the latter of which requires lifelong blood thinners.