What is valvular heart disease?
Valvular heart disease occurs when one or more of the heart’s valves become damaged or diseased, compromising their function. Valves play a crucial role in ensuring blood flows in the correct direction through the heart chamber and any disruption in their function can impair cardiac output and lead to symptoms and complications.
The heart contains four primary valves:
Facilitates blood flow from the left atrium to the left ventricle.
Serves as the primary outflow valve for the heart’s left side, enabling blood flow into the body.
Separates the heart’s right ventricle from the lungs.
Divides the upper and lower chambers (atrium and ventricle) on the right side of the heart.
Causes and risk factors
Several factors can contribute to the development of valvular heart disease, including:
- Age: Degenerative changes in the valves are common with aging leading to conditions such as calcific aortic stenosis and degenerative mitral valve disease.
- Congenital heart defects: Some people are born with abnormalities in the structure or function of heart valves, predisposing them to valvular heart disease.
- Rheumatic fever: Untreated streptococcal infections such as rheumatic fever can damage heart valves and lead to conditions such as rheumatic heart disease.
- Infective endocarditis: Bacterial or fungal infections of the heart valves can cause inflammation and damage, leading to valvular heart disease.
- Connective tissue disorders: Conditions such as Marfan syndrome or Ehlers-Danlos syndrome can affect the structure and function of heart valves.
- History of radiation therapy: Radiation therapy to the chest can increase the risk of valvular heart disease later in life.
Symptoms
There is a chance that valvular heart disease may not display symptoms until it is quite advanced. Some of these symptoms include:
- Chest pain
- Abdominal sweating
- Fatigue
- Dizziness and fainting
- Irregular heartbeat
- Shortness of breath
Why is valvular heart disease dangerous?
Heart valve diseases impair the functionality of the heart valves, affecting their capacity to operate effectively. They can cause the valves to become rigid and hindered in their opening (stenosis) or ineffective in closing properly (regurgitation). Consequently, this can lead to diminished blood flow through the valves or a reverse flow of blood within the heart, increasing the risk of complications such as blood clots, stroke and heart failure.
Diagnosis
Diagnosing valvular heart disease involves a comprehensive evaluation that may include various tests and assessments to determine the type and severity of the condition.
A thorough physical examination may reveal signs and symptoms suggestive of valvular heart disease, such as abnormal heart sounds (murmurs), fluid retention (oedema), or abnormal heart rhythms (arrhythmias).
Echocardiography uses sound waves to create images of the heart's structure and function, allowing clinicians to assess the valves' integrity, movement, and any abnormalities, such as stenosis (narrowing) or regurgitation (leakage).
An ECG measures the heart's electrical activity and can detect abnormal rhythms (arrhythmias) or changes suggestive of underlying heart valve abnormalities. While an ECG alone cannot diagnose valvular heart disease, it provides valuable information about the heart's electrical function and may prompt further evaluation.
A chest X-ray may be performed to assess the size and shape of the heart, as well as detect signs of fluid accumulation in the lungs (pulmonary congestion) or other abnormalities suggestive of valvular heart disease, such as valve calcification or enlargement of the heart chambers.
Cardiac MRI provides detailed images of the heart's structure and function, allowing for a comprehensive assessment of valvular abnormalities, including valve morphology, leakage, and narrowing. Cardiac MRI may be particularly useful in cases where echocardiography results are inconclusive or additional information is needed.
Stress tests may be performed to evaluate the heart's response to physical exertion and assess for signs of ischemia (inadequate blood flow) or abnormal valve function under stress conditions. Stress testing can help determine the severity of valvular heart disease and guide treatment decisions.
Treatments
The treatment of valvular heart disease aims to alleviate symptoms, improve heart function and reduce the risk of complications. Treatment options may include:
Such as following a balanced diet low in sodium and saturated fats, maintaining a healthy weight, engaging in regular exercise, quitting smoking, and managing stress.
Medications may be prescribed to manage symptoms, control blood pressure, prevent blood clots, and improve heart function. Commonly prescribed medications include diuretics (to reduce fluid build-up), beta-blockers (to slow the heart rate and reduce strain on the heart), ACE inhibitors or ARBs (to lower blood pressure), and anticoagulants (to prevent blood clots).
Valvuloplasty is a minimally invasive procedure used to restore proper blood flow and repair a narrowed or stenotic heart valve. This procedure is most commonly used to treat mitral valve stenosis or aortic valve stenosis.
Annuloplasty is a surgical procedure used to repair or reconstruct the ring-like structure (annulus) around a heart valve. This procedure may be performed to treat valve leakage by restoring the proper shape and function of the valve annulus.
In cases where valve damage is severe and repair is not feasible, heart valve replacement may be necessary. This can be done using either mechanical valves (made of durable materials such as metal or carbon) or bioprosthetic valves (made from animal tissue). Valve replacement surgery may involve replacing a single valve (such as the aortic or mitral valve) or multiple valves.
TAVI is a minimally invasive procedure used to replace a diseased aortic valve without open-heart surgery. During TAVI, a collapsible valve prosthesis is delivered through a catheter and implanted within the diseased valve, restoring proper blood flow.
More information
Learn more about the heart’s valves and the conditions which affect them:
Heart Valve Diseases – Johns Hopkins Medicine
Find out more about the diagnostic process for valvular heart disease and its treatment options:
Heart Valve Disease – Diagnosis and Treatment – Mayo Clinic
Access resources and read stories from other heart valve disease patients: