Heart valve disease occurs when the heart valves do not work the way they should.
Your heart valves lie at the exit of each of your four heart chambers and maintain one-way blood flow through your heart. The four heart valves make sure that blood always flows freely in a forward direction and that there is no backward leakage.
Blood flows from your right and left atria into your ventricles through the open tricuspid and mitral valves.
When the ventricles are full, the tricuspid and mitral valves shut. This prevents blood from flowing backward into the atria while the ventricles contract.
As the ventricles begin to contract, the pulmonic and aortic valves are forced open and blood is pumped out of the ventricles. Blood from the right ventricle passes through the open pulmonic valve into the pulmonary artery, and blood from the left ventricle passes through the open aortic valve into the aorta and the rest of the body.
When the ventricles finish contracting and begin to relax, the aortic and pulmonic valves shut. These valves prevent blood from flowing back into the ventricles.
This pattern is repeated over and over with each heartbeat, causing blood to flow continuously to the heart, lungs, and body.
There are several types of heart valve disease:
Heart valve disease can develop before birth (congenital) or can be acquired sometime during one's lifetime. Sometimes, the cause of valve disease is unknown.
Congenital valve disease. This form of valve disease most often affects the aortic or pulmonic valve. Valves may be the wrong size, have malformed leaflets, or have leaflets that are not attached correctly.
Bicuspid aortic valve disease is a congenital valve disease that affects the aortic valve. Instead of the normal three leaflets or cusps, the bicuspid aortic valve has only two. Without the third leaflet, the valve may be stiff (unable to open or close properly) or leaky (not able close tightly).
Acquired valve disease. This includes problems that develop with valves that were once normal. These may involve changes in the structure or your valve due to a variety of diseases or infections, including rheumatic fever or endocarditis.
There are many changes that can occur to the valves of the heart. The chordae tendinae or papillary muscles can stretch or tear; the annulus of the valve can dilate (become wide); or the valve leaflets can become fibrotic (stiff) and calcified.
Mitral valve prolapse (MVP) is a very common condition, affecting 1% to 2% of the population. MVP causes the leaflets of the mitral valve to flop back into the left atrium during the heart's contraction. MVP also causes the tissues of the valve to become abnormal and stretchy, causing the valve to leak. However, the condition rarely causes symptoms and usually doesn't require treatment.
Other causes of valve disease include: coronary artery disease, heart attack, cardiomyopathy (heart muscle disease), syphilis (a sexually transmitted disease), high blood pressure, aortic aneurysms, and connective tissue diseases. Less common causes of valve disease include tumors, some types of drugs, and radiation.
Symptoms of heart valve disease can include:
Symptoms of heart valve disease do not always relate to the seriousness of your condition. You may have no symptoms at all and have severe valve disease, requiring prompt treatment. Or, as with mitral valve prolapse, you may have noticeable symptoms, yet tests may show the valve leak is not significant.
Your heart doctor can tell if you have heart valve disease by talking to you about symptoms, performing a physical exam, and performing other tests.
During a physical exam, the doctor will listen to your heart to hear sounds the heart makes as the valves open and close. A murmur is a swishing sound made by blood flowing through a stenotic or leaky valve. A doctor can also tell if the heart is enlarged or if your heart rhythm is irregular.
The doctor will listen to the lungs to hear if you are retaining fluid there, which shows the heart is not able to pump as well as it should.
By examining your body, the doctor can find clues about circulation and the functioning of other organs.
After the physical exam, the doctor may order diagnostic tests. These may include:
By conducting some or all of these tests over time, your doctor can also see the progress of valve disease. This will help them make decisions about treatment.
Heart valve disease treatment depends on the type and severity of disease. There are three goals of treatment for heart valve disease: protecting your valve from further damage; lessening symptoms; and repairing or replacing valves.
Protecting your valve from further damage. If you have valve disease, you are at higher risk for developing endocarditis, a serious condition. People who have had their valve surgically repaired or replaced are also at higher risk for endocarditis.
To protect yourself:
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