The human heart has different valves (tricuspid, pulmonary, mitral and aortic valve) to ensure that blood flows in the right direction. They prevent the back flow of blood by opening and closing their flaps at correct intervals. Valvular heart disease (VHD) is the condition when one or more valves stop functioning properly, causing disruption in blood flow.
Causes
- Congenital
- Malformation of heart valves: The heart valves are irregular in shape, and the flaps are improperly attached.
- Bicuspid aortic valve disease: The bicuspid valve has only two flaps instead of three, which do not allow it to open or close properly. This causes a backflow of blood.
- Marfan syndrome: This affects the connective tissue and may lead to bicuspid valve prolapse and aortic valve regurgitation (backflow).
- Acquired
- Rheumatic fever: Untreated streptococcal bacterial infection in the throat causes strong immune system reactions. This may lead to scarring or inflammation of the heart valves.
- Infections: Infective endocarditis causes germs to attack the heart’s surface, enter the valves and cause damage. Syphilis infections weaken the aortic valves.
- Age-related
- Calcification: Calcium deposition on the valves leads to stenosis (narrowing).
- Degenerative valve disease: Valves tend to deteriorate with age. It may cause valve prolapse.
- Heart-related issues like cardiomyopathy, heart attack, atherosclerosis, and coronary artery disease are major causes.
- Radiation therapy: Exposure to radiation may make an individual more susceptible to valve fibrosis and calcification.
Signs or Symptoms
- Feeling of tightness in the chest
- Irregular heartbeat and palpitations
- Shortness of breath
- Constant fatigue
- Episodes of dizziness
- Fever
- Unexplained weight gain
- Heart murmur
- Swelling in body parts like feet, ankles or abdomen
- Pulmonary edema
Heart Valvular Disease Treatment
Depending upon the individual’s age, health and severity of the condition, one of the following remedies are suggested:
- Medication: Blood thinners, diuretics, and antiarrhythmics are prescribed to alleviate the symptoms. They prevent complications like hypertension and blood clots. Beta-blockers are administered to slow down the palpitations.
- Surgery: If valve repair or replacement is necessary, surgery has to be performed:
- Valve repair surgery: This is achieved through the removal of calcium deposits (commissurotomy and decalcification), reshaping and patching up the flaps, or tightening the ring supporting the valve (annuloplasty).
- Valve replacement surgery: If beyond repair, the surgeon replaces the valve with a mechanical (carbon, metal, or ceramic) one or a biological one (own or donated or animal tissue).
Risk Factors
- Age: Individuals above 60 years are more susceptible to the disease.
- Related health conditions: Individuals with diabetes, high blood pressure and cholesterol are more likely to develop this condition.
- Other heart diseases: People with a history of heart diseases like heart attack or cardiomyopathy should get themselves assessed periodically.
- Smoking: The chemicals may change the valve structure and cause disruption in its functioning.
- Family history: There is a possibility of a congenital risk factor.
- Autoimmune diseases: Lupus may cause inflammation in the heart valves.
- Diet medications: These may alter the structure of heart valves.
Stages
- At risk: The individual has one or more risk factors pertaining to the disease.
- Progressive: The individual is asymptomatic, and the situation is not that grave.
- Asymptomatic severe: Although heart valvular disease symptoms are not noticeable, the severity of the condition has increased.
- Symptomatic severe: The individual develops symptoms due to the severity of the disorder.
Typical Tests
The diagnosis for this condition involves a thorough physical examination that includes checking for heart murmur and fluid build-up. This is followed by a chest x-ray. An echocardiogram or electrocardiogram may be advised. Angiograms, cardiac MRIs, or CT scans may be needed before surgery. Routine blood tests are also done.
Primary Prevention
- Treating streptococcal throat infections with antibiotics.
- Reducing smoking and alcohol consumption.
- Exercising regularly.
- Eating healthy and reducing sodium intake.
- Maintaining dental hygiene to prevent infections.
Secondary Prevention
- Maintaining an active lifestyle.
- Reducing consumption of bad cholesterol food.
- Taking medications on time.
- Being regular with the follow-up visits.
- Watching out for secondary infections and getting them treated.
- Joining a support group for tips on exercise and rehabilitation.
Pathology:
- Valvular regurgitation: Also known as leaking of heart valves, this condition is caused due to the inability of the valves to close properly.
- Valvular stenosis: The valves stiffen and narrow. It restricts the blood flow and induces the heart to pump harder. This causes weakening of heart muscles.
- Valvular prolapse: There is a deformity in the tissue of the valves, which makes it slip backward loosely.
Alternate name
Heart Valve Disorder
Epidemiology
- Prevalence: About 2.5% of the population has VHD
- Age: Predominantly over 40 years but can also occur at early ages depending on the etiology.
- Gender: More prevalent in men above 60 years and women above 70 years of age
- Ethnicity: It is a global health issue
Expected Prognosis
Early diagnosis helps in deciding the mode of treatment - medicines or surgery. Timely surgery and frequent follow-ups prevent further damage and complications. Most types of VHD can be treated safely. The life expectancy after treatment can be brought to near-normal ranges.
Natural Progression
If left untreated, the condition degrades the quality of life. In the worst-case scenario, it may lead to blood clots, stroke, heart failure, or cardiac arrest.
Pathophysiology
The changes in valve structure cause failure of the flaps to open and close properly. This results in the back flow of blood. The atria and ventricles (upper and lower chambers of the heart) enlarge. The rise in pressure leads to inflammation and even pulmonary edema.
Possible Complications
As with any other procedure, the heart valve repair or replacement surgery, has some known possible complications. However, the success rates are much higher for these to be a cause for concern.
Our BLK-Max Medical Experts
If you are facing any similar signs or symptoms please contact the BLK-Max team to schedule an appointment at : +91-11-30403040
Give Feedback
.jpg?v=1)
JCI Accredited
