Valvular heart disease: symptoms, causes & treatment

Definition of heart valve disease

What is heart valve disease?

Heart valve disease is a disorder when the heart valves don't work properly. This disorder can occur in one or more valves located in your heart.

The heart has four valves that will close and open once with each beat, namely the mitral, tricuspid, pulmonary, and aortic valves. These valves ensure blood flows in the right direction, through the four chambers of the heart and throughout the body.

In heart valve abnormalities, one or more of the valves have an imperfect shape, so they cannot close and open properly.

If the valve is not functioning properly, blood can lead backwards making it difficult for the heart to flow properly.

Therefore, this condition can also cause the heart to leak because there is a small hole in the heart divider that cannot close and open properly.

In this condition, blood can accumulate in the heart and the heart needs to work even harder to pump blood. It is also difficult for other organs of the body to get enough blood as needed.

Over time, this condition can lead to other heart problems, such as heart failure, and even death.

How common is this disease?

Heart valve disease is a disorder that can happen to anyone. However, this condition is more often experienced by the elderly (elderly), because of the aging process in their bodies.

Some people may be born with heart valve disease, also known as congenital heart valve defects. Meanwhile, some other people experience this condition as adults, which is caused by other diseases, such as diabetes, blockage of blood vessels, or high blood pressure.

This disease can be managed by reducing the risk factors that affect the work of the heart. Talk to your doctor for more information.

Types of heart valve disease

As previously explained, the heart has four valves that ensure blood flows in the right direction. These four valves separate the four chambers of the heart and between the heart and the blood vessels leading to other organs.

The mitral valve is located between the left atrium and the left ventricle, while the tricuspid valve is between the right atrium and the right ventricle.

Meanwhile, the pulmonary valve separates the right ventricle from the pulmonary arteries leading to the lungs, while the aortic valve separates the left ventricle from the large arteries or aorta.

Each valve has a sheet or flap that opens and closes. Under normal conditions, each valve has three flaps that allow blood to pass through the valve.

In heart valve abnormalities, one or more of the valves has a problem, so blood can flow to places it shouldn't. Problems with these valves can vary.

Here are some types of conditions that can cause valve disease in the heart:

1. Stenosis

In stenosis, the valve becomes thick or stiff, and it may stick together or join together. This condition causes the valve not to open completely, so that the valve opening becomes narrow and blocks or restricts blood from flowing to the next chamber of the heart or other organs of the body.

In this condition, the heart needs to work harder to pump blood and other organs become deprived of nutrients and oxygen that is obtained through the blood. Over time, the heart becomes thicker and it becomes more difficult to pump blood.

Stenosis can be congenital or develop during the aging process or as a result of scar tissue that damages the valve.

This condition can also occur in the four valves in the heart, called aortic valve stenosis, pulmonary valve stenosis, mitral valve stenosis, and tricuspid valve stenosis.

2. Regurgitation

Regurgitation or insufficiency is also known as a heart valve leak. This condition occurs when the valve is unable to close completely, so blood flows back or blood returns to the previous heart chambers.

As a result of this condition, the blood flowing to the next chambers of the heart or to the arteries is limited. The heart also needs to work harder to pump blood and other body organs can lack the intake of nutrients and oxygen carried by the blood.

As with stenosis, regurgitation can occur in all four heart valves. Aortic valve regurgitation is generally due to congenital heart disease or other medical conditions, whereas pulmonary valve regurgitation can result from other medical conditions, such as pulmonary hypertension.

Mitral valve regurgitation is more common due to prolapse, which is a condition when the valve leaflet or flap swells and sticks out into the left atrium of the heart.

3. Atresia

In contrast to the other two types of heart valve disease, atresia occurs when the valve does not form or the valve flap network is dense, blocking blood flow between the chambers of the heart and to the arteries.

This condition generally occurs in the pulmonary and tricuspid valves, due to congenital abnormalities. In pulmonary atresia, blood cannot flow from the right ventricle to the pulmonary artery and into the lungs, so it has to go through another route.

As for tricuspid atresia, blood cannot flow normally from the right atrium to the right ventricle. As a result, the right ventricle becomes small and does not develop.

Signs & symptoms of heart valve disease

Some people with heart valve abnormalities or a leaky heart may not experience any symptoms for years. However, these people may still need treatment to prevent their disease from getting worse.

On the other hand, some other people may also experience certain symptoms. Reporting from the American Heart Association, these symptoms can appear suddenly and are very striking. The reason is, the symptoms of heart valve disease can also develop very quickly if the condition is severe.

However, for some people, this disease can also progress very slowly. In this condition, the heart has been able to compensate for the existing problems, so that the symptoms are almost undetectable.

However, the risks and damage to the heart due to this disease are still significant. Therefore, it is important for you to recognize the symptoms that may occur due to this heart valve abnormality.

Here are some common symptoms of heart valve disease:

Chest pain.
Fainting.
Dizzy.
Fatigue.
Shortness of breath, especially when very active or when resting.
Feeling a fast heartbeat or palpitations.
Abnormal heart sounds (heart murmur).
Irregular heartbeat.
Swelling of the feet and ankles.

There may be symptoms of a leaky heart not listed above. If you have concerns about a symptom, consult your doctor.

When to see a doctor?

If you have signs or symptoms of heart valve abnormalities as mentioned above, consult your doctor immediately. You may be referred to a cardiologist for a proper diagnosis.

You also need to see a doctor immediately if you feel sore throat is severe enough. This condition can develop into rheumatic fever, which is one of the causes of heart valve abnormalities, if not treated immediately.

Each body works in a different way. It's best to discuss with your doctor the best solution for your condition.

Causes & risk factors for heart valve disease

Heart valve abnormalities or leaky heart can occur due to congenital factors. This can be caused by incomplete heart development since it is still in the womb.

However, aging factors as well as heart conditions and other medical disorders can also cause the disease. These factors are said to change the shape or flexibility of the heart valves to be abnormal.

Here are some factors that can cause heart valve disorders or disease:

High blood pressure or hypertension that has developed.
Heart failure.
Atherosclerosis in the large arteries or aorta.
Tissue damage from a heart attack or injury to the heart.
Rheumatic fever, which is an inflammatory disease, which can occur due to untreated strep throat or other bacterial infection.
Infective endocarditis, which is inflammation of the heart tissue.
Aortic aneurysm, which is abnormal swelling or bulging of the aorta.
Autoimmune diseases, such as lupus, which can affect the aortic and mitral valves.
Carcinoid syndrome, a tumor in the digestive tract that spreads to the liver or lymph nodes, which can affect the tricuspid and pulmonary valves.
Diet drugs, such as fenfluramine and phentermine.
Metabolic disorders, such as Fabry disease and high blood cholesterol.
Radiation therapy to treat cancer.

What increases the risk of heart valve disease?

You are at higher risk for heart valve disease if you have one or more of the following:

Increasing age. As you age, your heart valves run the risk of thickening and becoming stiffer due to aging.
History of infective endocarditis, rheumatic fever, heart attack, or heart failure.
Have had valve disease before.
There are risk factors for coronary artery disease, such as high blood pressure, high blood cholesterol, smoking, insulin resistance, diabetes, obesity, lack of movement, and a family history of early heart disease.
Heart problems due to congenital factors.

Diagnosis & treatment of heart valve disease

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

To diagnose valve disease or a leaky heart, the doctor will ask for a medical history and perform a physical examination.

During the physical exam, the doctor will use a stethoscope to find out if there is an abnormal heart sound (heart murmur), which is a sign of a leaky heart.

If you are suspected of having this disease, your doctor may order some additional tests to confirm the diagnosis. Some of the tests you may need to undergo include:

Cardiac echocradiography or echo
Electrocardiography (EKG)
Chest X-ray
Cardiac catheterization
MRI of the heart
Exercise test or stress test

What are the treatment options for heart valve disease?

Basically, there is no cure for heart valve abnormalities. The treatment given is generally to control symptoms and delay the progression of the disease for the next few years.

To achieve this goal, there are several types of treatment for valve heart disease that doctors may give. This treatment is chosen depending on how severe your condition is.

Here are some types of medication or treatment for heart valve disorders that you may need to undergo, according to your condition:

Drugs

Your doctor may prescribe several medications for you to take. These drugs are generally given to control the symptoms you experience, especially if your condition is not severe. Some of the drugs that may be given, namely:

Medicines to lower blood pressure (antihypertensives), such as diuretics, beta blockers, ACE inhibitors, or vasodilators, and high cholesterol medications.
Medicines for arrhythmias (irregular heartbeats).
Anticoagulant drugs to prevent blood clots, are often given for types of mitral stenosis or congenital heart valve disorders that are at risk of causing blood clots.
Medicines to treat coronary artery disease.
Medication for heart failure.

Heart valve repair surgery

If your condition allows, your doctor may recommend performing heart valve repair surgery. Even if you don't feel any symptoms, this treatment procedure may still be recommended to prevent complications of this disease.

In this procedure, the surgeon will separate the attached or fused valve flap, replace the cable that supports the valve, remove excess valve tissue, or patch the hole in the valve.

The surgeon may also tighten or strengthen the ring around the valve by implanting an artificial ring.

Heart valve replacement surgery

If the valve cannot be repaired, the surgeon may perform heart valve replacement surgery. In this surgery, the surgeon will remove the damaged valve and replace it with a valve made of animal or human heart tissue.

A person who performs this valve replacement surgery generally needs to perform back replacement surgery at a certain time. This is because valves from animal or human heart tissue that are attached to your heart tend to degenerate.

Balloon valvuloplasty

Not only through surgical procedures, heart valve repair can also be done through a heart catheter procedure, which is called a balloon valvuloplasty. This procedure is generally given to patients with heart valve stenosis.

In this procedure, a catheter (thin tube) with a balloon at the end is inserted through a vein into the damaged heart valve. The balloon is then inflated to help expand the valve opening.

Generally, this procedure is given to valve disease patients who are still infants or children.

Transcatheter aortic valve implantation(TAVI)

Just like the above procedure, the TAVI procedure is also performed using a catheter and balloon valvuloplasty. However, these catheters and balloons are used to attach artificial valves to replace damaged heart valves.

This procedure is generally given to elderly patients, who are at risk of developing complications after heart surgery.

Home remedies for heart valve disease

In addition to medical treatment, doctors will also recommend making lifestyle changes to help treat a leaky heart. Here are some lifestyles that you need to adopt everyday anywhere, including at home:

Control high blood pressure and high cholesterol levels, including by eating foods low in bad fats and low in sodium (salt).
Lose weight if you are overweight.
Do exercise for heart disease regularly, according to the doctor's advice.
See a doctor for regular check-ups.
Do not use non-prescription drugs if they are not recommended by your doctor.

If you have any questions, consult your doctor to find the best solution.