Valvular Heart Disease

What is valvular heart disease?

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Valvular heart disease is a condition that occurs when any valve in the heart is diseased. Valvular heart disease can impact any of the heart’s valves: the tricuspid, pulmonary, mitral, and aortic. These gateways allow blood to flow through the heart and out into the arteries. More generally, heart valves ensure that blood flows in a forward direction. They also prevent leakage or back-ups.

Blood flows to the rest of the body from the upper and lower chambers of the heart. Heart valves open and close to ensure that blood can flow undisrupted. Valvular heart disease, also referred to as valvulopathy, occurs when this mechanism is damaged.

There are four types of valvular heart disease: valvular regurgitation, mitral valve prolapse, valvular stenosis, and bicuspid aortic valve disease. A person can experience more than one type of valvular heart disease at a time. If you think you may have this condition, it is essential to see a cardiologist as soon as possible, especially is symptoms are disruptive. Early treatment and management can improve quality of life.

What are the different types of valvular heart diseases?

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There are four different types of valvular heart disease: valvular regurgitation, mitral valve prolapse, valvular stenosis, and bicuspid aortic valve disease.

  • Valvular regurgitation, also referred to as “leaky valve,” occurs when a valve does not close correctly. Blood begins to flow backwards. This valvular heart disease can happen in any of the four valves. Treatment varies based on severity of symptoms.
  • Mitral valve prolapse is a very common valvular heart disease. It occurs when the mitral flaps become floppy and do not close. This can cause blood to flow back to the left atrium. Mitral valve prolapse is also referred to as balloon mitral valve, Barlow’s syndrome, click-murmur syndrome, or floppy valve syndrome. Many cases of mitral valve prolapse present no symptoms and do not require treatment.
  • Valvular stenosis occurs when a valve does not open enough and prevents blood from flowing through the valve. “Stenosis” means narrowing. This valvular heart disease can happen in any of the valves. If the heart valve thickens or stiffens, the patient might experience valvular stenosis. Some cases of valvular stenosis do not require treatment.
  • Bicuspid aortic valve disease is a congenital birth defect in which the patient has two flaps on their aortic valve instead of the usual three flaps. Some people with bicuspid aortic valve disease do not present symptoms, while others will present symptoms at birth.

 

What causes valvular heart disease?

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Valvular heart disease has a range of possible causes. Some valvular heart diseases are caused by congenital defects. Other valvular heart diseases are attributed to aging. There is no one singular cause of valvular heart disease. In fact, a number of conditions can cause or increase risk of valvular heart disease. The list below outlines conditions that could eventually cause someone to develop valvular heart disease.

  • Heart attack
  • Syphilis
  • Aortic aneurysm
  • Rheumatic fever
  • Hypertension
  • Atherosclerosis
  • Infective endocarditis
  • Cardiomyopathy
  • Coronary artery disease
  • Cardiac or valvular congenital defect

What are symptoms of valvular heart disease?

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It is possible for some people to experience asymptomatic valvular heart disease. Mild cases of valvular heart disease are common and often go completely undetected. However, symptomatic valvular heart disease can pose a critical threat to a person’s health.

An irregular heart rate, heart murmur, water retention, or pulmonary edema are strong indications of valvular heart disease, regardless of which type might be the ultimate diagnosis. While the four valvular heart diseases do share some symptoms, each is distinct enough to warrant knowledge of the warning signs.

  • Symptoms of valvular regurgitation include fatigue, cough, shortness of breath, heart palpitations, lightheadedness, and swollen ankles and feet.
  • Symptoms of mitral valve prolapse include fatigue, cough, shortness of breath, heart palpitations, and chest pain.
  • Symptoms of valvular stenosis include fatigue, fainting, dizziness, shortness of breath, and chest pain.
  • Symptoms of bicuspid aortic valve disease include fainting, dizziness, shortness of breath under exertion, and chest pain.

Are there any risk factors or groups for valvular heart disease?

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Aging is likely the biggest risk factor for developing valvular heart disease. Aside from old age, risk for valvular heart disease is associated with a myriad of other health complications. Valvular heart disease often develops as a result of an existing condition, some of which are listed below.

  • Rheumatic fever
  • Infective endocarditis (Note: Intravenous drug use can increase chances of infective endocarditis, and thus increase risk for valvular heart disease.)
  • Arrhythmia
  • Heart attack
  • Heart failure
  • Radiation therapy in the chest as a result of childhood cancer
  • Congenital heart defects
  • Previous history of heart valve disease

How is valvular heart disease diagnosed?

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A doctor checks for symptoms of valvular heart disease at a routine physical. During the check-up, a doctor will monitor the patient’s heart rate to identify irregularities, check their lungs for fluid buildup, and look for any indication of swelling, or water retention. These are all strong indicators of valvular heart disease.

Other methods of diagnosis may include:

  • MRI scan
  • Stress test
  • Cardiac catheterization
  • Electrocardiogram
  • Echocardiogram
  • Chest x-ray

How is valvular heart disease treated?

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Treatment plans for valvular heart disease vary based on the type of valvular heart disease and the severity of symptoms. Initial treatment for a mild case of valvular heart disease could include increasing medical supervision, quitting smoking, and creating a healthy diet plan.

  • Valvular regurgitation treatment might require medication to keep fluid from accumulating. If symptoms are severe, the patient will undergo surgery to repair or completely replace the affected valve.
  • Mitral valve prolapse treatment requires surgery if the patient presents symptoms.  The patient will undergo surgery to repair or completely replace the mitral valve. Most cases of mitral valve prolapse do not cause symptoms.
  • Valvular stenosis treatment might involve a valvuloplasty, or a balloon that dilates the valve. Depending on the severity of the case, the patient will undergo surgery to repair or completely replace the affected valve.
  • Bicuspid aortic valve disease treatment usually occurs when patients are in their 30s or 40s. About 80% of people with bicuspid aortic valve disease will undergo surgery to repair or completely replace the aortic valve.

Medications for valvular heart disease include diuretics to decrease fluid retention, vasodilators to dilate blood vessels, and beta-blockers and calcium channel blockers to regulate blood flow and heart rate.

 

What sets valvular heart disease apart from other types of heart disease?

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Valvular heart disease is not as common as other heart diseases, though cases are on the rise due to longer life expectancies. Some cases of valvular heart disease are congenital, meaning the patient is born with a defect that causes the disease. Not all cases of valvular heart disease are congenital.

Additionally, valvular heart disease is different from other types of heart disease because it specifically targets the flow of blood between the heart’s valves, and beyond. Coronary artery disease, for example, targets the heart’s major blood vessels.

Should you see a doctor for valvular heart disease?

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Some mild cases of valvular heart disease will not present symptoms at all. That being said, patients with abnormal symptoms should involve a doctor in the treatment process as soon as they notice those symptoms. Treatment plans can be extremely involved, with frequent supervision, medications, or even surgery. The support of a dedicated care team is invaluable to a patient with valvular heart disease. Even an extremely mild case of valvular heart disease would prompt routine physicals and extra checkups for any new symptoms that arise.

An early diagnosis means that treatment can begin as soon, and as aggressively, as possible.

What is the outlook for people living with valvular heart disease?

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Valvular heart disease is not a universal experience, and the severity of cases varies from patient to patient. Mild cases of valvular heart disease will often present no symptoms. They can also have very little impact on the patient’s life. Some people can have valvular heart disease without ever knowing of their condition.

However, more severe valvular heart disease can cause disruptive symptoms. Untreated valvular heart disease can result in serious health ramifications. Treatment and outlook for people with valvular heart disease differ based on the type and severity of valvular heart disease. Patients with valvular heart disease should expect a healthy life expectancy, and quality of life, if their treatment plan includes the necessary maintenance, medication, or surgery.

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