Heart Valve Diseases

Heart Valve Diseases

Anatomy of the heart, view of the valves
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What are heart valves?

The heart consists of four chambers -- two atria (upper chambers) and two ventricles (lower chambers). There is a valve through which blood passes before leaving each chamber of the heart. The valves prevent the backward flow of blood. They act as one-way inlets of blood on one side of a ventricle and one-way outlets of blood on the other side of a ventricle. The four heart valves include the following:

How do the heart valves function?

As the heart muscle contracts and relaxes, the valves open and close, letting blood flow into the ventricles and out to the body at alternate times. The following is a step-by-step illustration of how the valves function normally in the left ventricle:

What is heart valve disease?

Heart valve disorders can arise from two main types of malfunctions:

Heart valves can develop both malfunctions at the same time (regurgitation and stenosis). Also, more than one heart valve can be affected at the same time. When heart valves fail to open and close properly, the implications for the heart can be serious, possibly hampering the heart's ability to pump blood adequately through the body. Heart valve problems are one cause of heart failure.

What are the symptoms of heart valve disease?

Mild heart valve disease may not cause any symptoms. The following are the most common symptoms of heart valve disease. However, each individual may experience symptoms differently. Symptoms may vary depending on the type of heart valve disease present and may include:

Symptoms of heart valve disease may resemble other medical conditions and problems. Always consult your physician for a diagnosis.

What causes heart valve damage?

The causes of heart valve damage vary depending on the type of disease present, and may include the following:

The mitral and aortic valves are most often affected by heart valve disease. Some of the more common heart valve diseases include:

Heart Valve DiseaseSymptoms and Causes
Bicuspid aortic valve
This congenital birth defect is characterized by an aortic valve that has only two flaps (a normal aortic valve has three flaps). If the valve becomes narrowed, it is more difficult for the blood to flow through, and often the blood leaks backward. Symptoms usually do not develop during childhood, but are often detected during the adult years.
Mitral valve prolapse (also known as click-murmur syndrome, Barlow's syndrome, balloon mitral valve, or floppy valve syndrome)
This disease is characterized by the bulging of one or both of the mitral valve flaps during the contraction of the heart. One or both of the flaps may not close properly, allowing the blood to leak backward. This may result in a mitral regurgitation murmur.
Mitral valve stenosis
Often caused by a past history of rheumatic fever, this condition is characterized by a narrowing of the mitral valve opening, increasing resistance to blood flow from the left atrium to the left ventricle.
Aortic valve stenosis
This type of valve disease occurs primarily in the elderly and is characterized by a narrowing of the aortic valve opening, increasing resistance to blood flow from the left ventricle to the aorta.
Pulmonary stenosis
This condition is characterized by a pulmonary valve that does not open sufficiently, causing the right ventricle to pump harder and enlarge.

How is heart valve disease diagnosed?

Heart valve disease may be suspected if the heart sounds heard through a stethoscope are abnormal. This is usually the first step in diagnosing a heart valve disease. A characteristic heart murmur (abnormal sounds in the heart due to turbulent blood flow across the valve) can often indicate valve regurgitation or stenosis. To further define the type of valve disease and extent of the valve damage, physicians may use any of the following diagnostic procedures:

Heart valve disease and surgical procedures

A person with heart valve disease will often need to take antibiotics before undergoing dental or other surgical procedures that cause bleeding. Antibiotics are also recommended by physicians and dentists before routine professional teeth cleaning and other procedures involving the gums or soft tissues of the mouth. Bacteria released during these and other procedures may enter the bloodstream and lodge in the heart on the vulnerable, diseased heart valve. The antibiotics help prevent against a potentially fatal infection called endocarditis, an infection of the heart's lining.

In addition, inform your dentist and other physicians if you are taking any anticoagulant medication (to prevent blood clots), because this medication can cause excessive bleeding during surgery.

Always inform your dentist and other physician(s) if you have heart valve disease.

What is the treatment for heart valve disease?

In some cases, the only treatment for heart valve disease may be careful medical supervision. However, other treatment options may include medication, surgery to repair the valve, or surgery to replace the valve. Specific treatment will be determined by your physician based on:

Treatment varies, depending on the type of heart valve disease, and may include one, or a combination of, the following:

Medication

Medications are not a cure for heart valve disease but in many cases are successful in the treatment of symptoms caused by heart valve disease. These medications may include:

Surgery

Surgery may be necessary to repair or replace the malfunctioning valve(s). Surgery may include:

Another treatment option that is less invasive than valve repair/replacement surgery is balloon valvuloplasty, a non-surgical procedure in which a special catheter (hollow tube) is threaded into a blood vessel in the groin and guided into the heart. The catheter, which contains a deflated balloon, is inserted into the narrowed heart valve. Once in place, the balloon is inflated to stretch the valve open. The balloon is then removed. This procedure is often used to treat pulmonary stenosis and, in some cases, aortic stenosis.

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