Heart Valve Disorders
Heart valve disorders can affect any of the valves in the heart. The heart valves have flaps that open and close with each heartbeat, allowing blood to flow through the heart’s upper (atria) and lower (ventricles) chambers and to the rest of the body.
The heart has four valves:
- tricuspid valve, which is located between the right atrium and right ventricle
- pulmonary valve, located between the right atrium and the pulmonary artery
- mitral valve, which is located between the left atrium and left ventricle
- aortic valve, located between the left ventricle and the aorta
Blood flows from the right and left atria via the tricuspid and mitral valves, which open to allow blood to flow into the right and left ventricles. These valves then close to prevent blood from flowing back into the atria. Once the ventricles have filled with blood, they begin to contract, forcing the pulmonary and aortic valves to open. Blood then flows to the pulmonary artery and aorta, respectively. The pulmonary artery carries deoxygenated blood from the heart to the lungs and the aorta, the body’s largest artery, is responsible for carrying oxygen-rich blood to the rest of the body.
Essentially, the heart valves work by ensuring that blood flows in a forward direction and does not back-up or cause leakage. When an individual has a heart valve disorder, the valve is not able to do this job properly. This can be caused by regurgitation (leakage of blood), stenosis (narrowing of the valve opening), or a combination of both.
Some individuals may experience no symptoms, while others may experience conditions like strokes, heart attacks, and blood clots if the heart valve disorder goes untreated.
Heart Valve Disorders
Mitral Valve Prolapse
This may also be called floppy valve syndrome, click-murmur syndrome, balloon mitral valve, or Barlow’s syndrome. It occurs when the mitral valve does not close properly, sometimes causing blood to flow back into the left atrium.
Most people with mitral valve prolapse do not experience symptoms and do not require treatment as a result. However, symptoms such as heart palpitations, shortness of breath, chest pain, fatigue, and cough may indicate that treatment is necessary.
Treatment involves surgery to repair or replace the mitral valve.
Bicuspid Aortic Valve Disease
This occurs when an individual is born with an aortic valve that has two flaps instead of the usual three. In very severe cases, symptoms of this type of disorder are present at birth. However, some people may go decades without knowing they have this type of disorder. The valve is usually able to function for years without causing symptoms, so most individuals with bicuspid aortic valve disease are usually not diagnosed until adulthood. According to the Cleveland Clinic, 80 percent of people with this type of heart valve disorder will require surgery to repair or replace the valve, which typically happens when they are in their 30s or 40s. (Cleveland Clinic, 2012)
Symptoms may include shortness of breath with exertion, chest pain, and dizziness or fainting. Most individuals are able to have their aortic valve repaired successfully with surgery.
This occurs when a valve is not able to open completely, which means that not enough blood is able to flow through the valve. This can occur in any of the heart valves and may be caused by the heart valve thickening or stiffening.
Symptoms may include chest pain, shortness of breath, fatigue, dizziness, and fainting. Some individuals do not require treatment. Other individuals may require valvuloplasty, which uses a balloon to inflate the valve, or valve replacement surgery.
This may be also called “leaky valve” and occurs when any of the heart valves do not close properly, causing blood to flow backwards. Symptoms can include shortness of breath, cough, fatigue, heart palpitations, light-headedness, and swelling of the feet and ankles.
The effects of valvular regurgitation vary from person to person. Some people need to have their condition monitored. Others may need to have medication prescribed to prevent fluid build-up, while others require valve repair or replacement.
Causes of Heart Valve Disorders
There are a number of causes for the different heart valve disorders. Causes may include:
- birth defects
- infective endocarditis—inflammation of the heart tissue
- rheumatic fever—inflammatory disease brought on by group A streptococcal infection
- age-related changes, such as calcium deposits
- heart attacks
- coronary artery disease (narrowing and hardening of arteries that supply the heart)
- cardiomyopathy—degenerative changes in the heart muscle
- syphilis—a relatively rare sexually transmitted infection
- hypertension (high blood pressure)
- aortic aneurysms—abnormal swelling or bulging of the aorta
- atherosclerosis—hardening of the arteries
- myxomatous degeneration—weakening of connective tissue in the mitral valve
- lupus—a chronic autoimmune disorder
Symptoms of Heart Valve Disorders
Symptoms of heart valve disorders vary depending on the severity of the disorder. Usually, the presence of symptoms indicates that the disorder is affecting blood flow. Many individuals with mild or moderate heart valve disorders do not experience any symptoms. However, symptoms may include:
- shortness of breath
- heart palpitations
- chest pain
- dizziness and fainting
- water retention or swelling in the lower extremities and abdomen
- pulmonary edema or excess fluid in the lungs
How Are Heart Valve Disorders Diagnosed?
If you are experiencing symptoms of a heart valve disorder, your doctor will begin by listening to your heart with a stethoscope. He or she is listening for any heart rate abnormalities, which could indicate a problem with the heart valves. Your doctor may also listen to your lungs to determine if there is fluid build-up, as well as check your body for signs of water retention, both symptoms of heart valve problems.
Other tests that may be used to diagnose heart valve disorders include:
- electrocardiogram (ECG) is a test that shows the electrical activity of the heart. This test is used to check for abnormal heart rhythms.
- an echocardiogram uses sound waves to create a picture of the heart valves and chambers.
- cardiac catheterization is another test used to diagnose valve disorders. This test uses a thin tube or catheter with a camera to take pictures of your heart and blood vessels. This can help your doctor determine the type and severity of your valve disorder.
- a chest X-ray may be ordered to take a picture of your heart. This can tell your doctor if your heart is enlarged.
magnetic resonance imaging (MRI) may provide a more detailed picture of your heart. This can help confirm a diagnosis and help your doctor determine how to best treat your valve disorder.
- a stress test can also be used to determine how your symptoms are affected by exertion. The information from the stress test can help your doctor determine the severity of your condition.
Treatments for heart valve disorders depend on the severity of the disorder and symptoms. Most doctors suggest beginning with conservative treatment. This includes:
- consistent medical supervision
- quitting smoking
- following a healthy diet
Medications that are usually prescribed are:
- beta-blockers and calcium channel blockers that help control heart rate and blood flow
- diuretics to reduce fluid retention
- vasodilators—drugs that open or dilate blood vessels
Surgery may be required if symptoms increase in severity. This may include heart valve repair using the patient’s own tissues or heart valve replacement using animal valves (biological valve replacement), donated valves, or mechanical (artificial) valves.
Valvuloplasty may also be used to treat stenosis. A small balloon is inserted into the heart where it is inflated slightly. The inflation increases the size of the opening in the valve and then the balloon is removed.