Valvular Heart Disease Explained

Valvular Heart Disease (VHD) refers to any condition that affects one or more of the heart’s four valves, disrupting the normal flow of blood through the heart. The heart valves ensure that blood flows in the correct direction through the heart’s chambers. When these valves are damaged or diseased, they may not open or close properly, leading to problems such as leakage (regurgitation) or narrowing (stenosis).

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Types of Heart Valves

The heart has four valves:

1. Mitral Valve: Between the left atrium and left ventricle.
2. Aortic Valve: Between the left ventricle and the aorta.
3. Tricuspid Valve: Between the right atrium and right ventricle.
4. Pulmonary Valve: Between the right ventricle and the pulmonary artery.

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Types of Valvular Heart Disease

1. Valve Stenosis:
   • The valve opening becomes narrowed, restricting blood flow.
   • Example: Aortic stenosis (narrowing of the aortic valve).
2. Valve Regurgitation (Insufficiency):
   • The valve does not close properly, causing blood to leak backward.
   • Example: Mitral regurgitation (leakage of the mitral valve).
3. Valve Prolapse:
   • The valve flaps bulge or collapse backward into the upper chamber, often causing regurgitation.
   • Example: Mitral valve prolapse.
4. Congenital Valve Defects:
   • Abnormalities in valve structure present from birth.
   • Example: Bicuspid aortic valve (aortic valve has two leaflets instead of three).

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Causes of Valvular Heart Disease

1. Aging:
   • Wear and tear over time can cause valve thickening or calcification (e.g., aortic stenosis).
2. Infections:
   • Rheumatic fever (a complication of untreated strep throat) can damage heart valves.
   • Infective endocarditis (a bacterial infection of the heart valves).
3. Congenital Defects:
   • Some people are born with abnormal valves (e.g., bicuspid aortic valve).
4. Degenerative Conditions:
   • Conditions like mitral valve prolapse or calcific aortic stenosis.
5. Other Heart Conditions:
   • Cardiomyopathy, heart attack, or heart failure can affect valve function.
6. Other Causes:
   • Radiation therapy, certain medications, or autoimmune diseases (e.g., lupus).

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Symptoms of Valvular Heart Disease

Symptoms depend on the affected valve and the severity of the condition. Common symptoms include:

• Shortness of breath (especially during activity or when lying down)
• Fatigue or weakness
• Swelling in the legs, ankles, or feet (edema)
• Chest pain or discomfort (angina)
• Heart palpitations (irregular or rapid heartbeat)
• Dizziness or fainting (syncope)
• Persistent cough, sometimes with blood-tinged mucus

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Diagnosis

To diagnose valvular heart disease, a doctor may perform:

1. Physical Exam:
   • Listening for heart murmurs (abnormal sounds caused by turbulent blood flow).
2. Echocardiogram:
   • Uses ultrasound to visualize the heart’s structure and valve function.
3. Electrocardiogram (ECG/EKG):
   • Records the heart’s electrical activity to detect arrhythmias.
4. Chest X-ray:
   • Shows the heart’s size and shape, as well as signs of fluid buildup.
5. Cardiac MRI or CT Scan:
   • Provides detailed images of the heart and valves.
6. Stress Test:
   • Evaluates how the heart performs under physical exertion.
7. Cardiac Catheterization:
   • Measures pressure and blood flow in the heart chambers.

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Treatment Options

Treatment depends on the type and severity of the valve disease. Options include:

1. Lifestyle Changes:
   • Eating a heart-healthy diet, exercising, quitting smoking, and managing stress.
2. Medications:
   • Diuretics: Reduce fluid buildup.
   • Beta-blockers or Calcium Channel Blockers: Control heart rate and blood pressure.
   • Anticoagulants: Prevent blood clots (e.g., in atrial fibrillation).
3. Surgical Interventions:
   • Valve Repair: Preserves the existing valve (e.g., mitral valve repair).
   • Valve Replacement:
     • Mechanical Valve: Made of durable materials (requires lifelong blood thinners).
     • Biological Valve: Made from animal or human tissue (may need replacement over time).
   • Minimally Invasive Procedures:
     • Transcatheter Aortic Valve Replacement (TAVR): Replaces the aortic valve without open-heart surgery.
4. Monitoring:
   • Regular follow-ups to monitor valve function and overall heart health.

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Complications of Untreated Valvular Heart Disease

If left untreated, valvular heart disease can lead to:

• Heart failure
• Stroke
• Blood clots
• Arrhythmias (e.g., atrial fibrillation)
• Sudden cardiac arrest (in severe cases)

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Prevention

While some causes (e.g., congenital defects) cannot be prevented, you can reduce your risk by:

• Treating strep throat promptly to prevent rheumatic fever.
• Managing conditions like high blood pressure, diabetes, and high cholesterol.
• Practicing good dental hygiene to prevent infections that could spread to the heart.
• Avoiding smoking and excessive alcohol consumption.

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If you suspect you have valvular heart disease or are experiencing symptoms, consult a healthcare provider for evaluation and appropriate management. Early diagnosis and treatment can significantly improve outcomes and quality of life.