Introduction:
Valvular heart disease is when the heart's valves don't work properly. About 4 percent of people over 65 have this issue in developed countries. Some people might already know they have a valve problem, or it could be detected before surgery. When a doctor is preparing for surgery, they need to:
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Understand how severe the heart valve problem is for the upcoming surgery.
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Plan the anesthesia based on how the heart is functioning.
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Make sure to give antibiotics to prevent infections.
Special heart tests like echocardiography show how the valves move and shape. But these tests, except for mitral stenosis, can only sometimes tell how severe the problem is. Another test, Doppler echocardiography, helps estimate how narrow a valve is or how much blood is leaking backward.
What Is a Cardiac Valvular Disease?
Valvular heart disease happens when the heart's valves are damaged or not working well. The heart has four chambers and four valves that control blood flow. These valves make sure blood goes in the right direction.
There are different valves with different names: mitral valve, tricuspid valve, aortic valve, and pulmonary valve. They open and close to let blood in and out. The tricuspid valve has three parts that work together, while the mitral valve has two parts.
In a healthy heart, the valves fully open and close during each heartbeat. But in a diseased heart, the valves might not work properly. The aortic valve is often affected. When a valve is diseased, it might not close completely, causing "regurgitation." This means blood leaks backward instead of moving forward, leading to problems.
What Are the Possible Injuries That Occur During Anesthesia Administration?
Anesthesia is a key part of medical procedures like surgery. It usually goes well, but sometimes rare mistakes or accidents happen. These can lead to various injuries. One common issue is hurting teeth when putting a tube for breathing. Anesthesia can also damage nerves or even organs, like the heart.
One scary situation is feeling pain or awake during surgery because of too little anesthesia. This can cause stress or other problems later. Anesthesia mistakes can even be deadly, causing coma or death. Not enough oxygen during surgery can harm the brain.
Anesthesia-related deaths have decreased over time thanks to safety rules and better training. But there's still room to improve and make surgeries safer.
Doctors need to combine modern tools with good training, supervision, and careful practices to keep patients safe during anesthesia.
How Anesthesia Reacts in People With Various Heart Problems?
Anesthesia and surgery can affect the heart and blood circulation. Even in healthy people, the drugs used for anesthesia can make the heart work less effectively and cause low blood pressure. Some drugs might make the heart seem better by speeding it up, but they can also weaken it. Anesthesia can be especially risky for people with heart problems, as their hearts can't handle significant changes well. People might not know they have heart problems until they're put to sleep for surgery. The surgery can also stress the heart, causing problems like changes in blood volume, the release of substances, low body temperature, and sudden changes in how the heart works. All of this can make the heart work harder and might not be obvious because of the effects of anesthesia.
What Are the Injuries That Occur in the Heart Valve During Anesthetic Administration?
The most common cardiac valvular injury during anesthetic administration is damage or malfunction of the heart valves.
Valve Regurgitation:
Regurgitation is like a leaking valve in the heart. Sometimes it's not a big problem, but other times it makes the heart work too hard. This can lead to the heart not pumping blood as well.
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Leaking happens when:
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Blood goes backward through the valve while it's closing.
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Blood leaks through a valve that doesn't close properly.
For example:
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When the heart's mitral valve's door-like flaps don't close tightly, it can cause mitral valve regurgitation. As a result, blood may start to flow backwards rather than forward. These flaps usually control the blood flow from one heart chamber to another. If they don't close tightly or the valve changes shape, blood can leak incorrectly. This leaking is called mitral regurgitation, the most common valve problem.
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Aortic regurgitation, commonly referred to as aortic insufficiency, is a condition affecting the heart valve that regulates blood flow. This valve has flaps that should close tightly, but if they don't, it becomes leaky. This means some blood flows back into the heart's pumping chamber. Because of this leak, the pumping chamber has to work harder to push blood out. Over time, it can get bigger and weaker, which might lead to heart problems.
Valve Stenosis:
Aortic stenosis is a major issue with a heart valve. It happens when the valve narrows, which can be like a failing valve. This narrowing limits the blood going out of the heart and can also affect the pressure inside the heart. While some are born with this due to a heart defect, it's usually caused by aging, where the valve gets damaged and doesn't let enough blood through.
Rupture of a Valve Leaflet:
When the aortic valve is damaged, it can create a unique sound, like a musical note when the heart beats. This sound can be loud and may come with a buzzing sensation. Aortic regurgitation, where blood leaks back into the heart, is a severe issue. It makes the heart work harder and become larger. It can result from heart defects or infections, causing pain or difficulty breathing. Sadly, it can lead to heart failure.
Conclusion:
Damage or malfunction of the heart valves can occur during anesthesia, resulting in cardiac valvular injuries. Anesthesia and surgery can strain the heart and its valves, especially in people with heart problems. Anesthesia, changes in blood flow, and other conditions can all cause issues with the correct opening and closing of heart valves. This can cause valve regurgitation, stenosis, or even valve leaflet rupture. These injuries can impair the heart's ability to pump blood adequately and may necessitate additional medical intervention or surgery to rectify.
