Heart Valve Disease

What is heart valve disease?

Heart valve disease is condition where the flaps regulate the direction of blood flow through the heart are malfunctioning. The valves of the heart open and close to direct unidirectional blood flow through the heart. In heart valve disease there is disturbance in blood movement through the heart. There are various conditions that can lead to heart valve disease – some affect the valves in a short period of time but most develop over years and decades.

The heart has four valves –

  1. Aortic valve
  2. Mitral valve
  3. Pulmonary valve
  4. Tricuspid valve

The valves are made of tissue flaps. These flaps open and close with each heartbeat to maintain proper blood flow. When damaged, the opening of valves can become narrow (stenosis), there may be backward flow of blood (regurgitation or insufficiency) or the valves may not close properly (prolapse).

What are the symptoms of heart valve disease?

The symptoms of heart valve disease vary. It depends on which of the valves are not working properly and the way in which it is malfunctioning. The common symptoms reported in all types of heart valve disease includes:

  • Breathlessness
  • Irregular heartbeat
  • Chest pain
  • Fatigue
  • Swelling in feet and ankles
  • Fainting

What causes heart valve disease?

  • A congenital defect (present at birth) in one of the aortic, pulmonary, mitral, and tricuspid valves may lead to heart valve disease.
  • Certain medical conditions can also damage the valves.
  • Infections can also lead to heart valve disease. An example is infectious endocarditis where a bacterial or fungal infection of heart valves damages them.
  • Some connective tissue disorders may also result in heart valve disease.
  • Use of certain medications (like, ergotamine, radiation therapy for cancer) can lead to heart valve disease.

What is the treatment for heart valve disease?

Treatment of heart valve disease depends on the severity of the condition and type of heart valve disease. Treatment options involve:

  • Catheter-based valvuloplasty uses a balloon catheter to widen a stenotic or narrowed valve. The procedures involved are valvotomy or percutaneous balloon commissurotomy. In valvotomy, a constricted heart valve is cut surgically to relieve obstruction.
  • Surgical commissurotomy is commonly done on mitral valve. This process involves making one or more incisions at the edges of the commissure to relieve constriction.
  • Valve repair and valve replacement surgeries are frequently recommended to patients. Mechanical (manufactured) or bio-prosthetic (made of pig heart) valves are used as prostheses in open-heart surgeries. Mechanical valves are preferred for use in patients with high life expectancy as bio-prosthetic valves tend to deteriorate after 10 to 12 years.

Patients need to take anti-coagulants (medications that prevent blood clotting) for the rest of their lives. This decreases the risks of a blood clot to form anywhere in the body and block the heart blood vessels.  In pregnant women, the use of a common anticoagulant known as warfarin in mechanical valves increases the risk of developmental anomalies in fetus in pregnant women. In some cases, the use of another anti-coagulant known as heparin instead of warfarin is recommended but the management is very difficult.

One way of preventing heart valves disease is through the use of antibiotics before any dental or medical procedures to prevent bacterial infection of heart valves.

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