Valvular Heart Disease - Causes, Symptoms, Diagnosis, and Treatment

Introduction

Valvular heart disease is a cardiovascular condition that results in damage or any valve in the heart. Valves are a crucial part of the heart’s structure. They open and close as the blood passes through them. They mainly regulate the entry and exit of blood into the heart’s various chambers. The valves have flaps or leaflets that open and close. Valves with three leaflets open and close simultaneously. In order to avoid any sort of backflow of blood, the leaflets close, and vice versa is why they open.

When a valve is damaged or diseased, they do not open and close efficiently and eventually becomes leaky. This phenomenon is called regurgitation. Due to this, the backflow of blood is not stopped, and thus, blood goes back to the chamber it came from. Stenosis is another type of valve disorder where the leaflets turn stiff and narrow. There are other cases where a leaflet is missing, which is generally found in the aortic valve. All the above leads the heart to work harder, which eventually gives up by being tired, leading to heart failure and sudden cardiac arrest.

• The heart has four chambers - two upper sections called the right atrium and left atrium, and two lower sections called the right ventricle and left ventricles.

• Parallel to four chambers, the heart has four valves - mitral valve, tricuspid valve, aortic valve, and pulmonary valve.

• The mitral valve or the bicuspid valve allows blood to flow smoothly from the left atrium into the left ventricle. It has two leaflets.

• The tricuspid valve allows blood to flow easily from the right atrium into the right ventricle. It has three leaflets.

• The aortic valve controls smooth blood flow from the left ventricle to the aorta. Aorta is known to be the largest blood vessel of the heart as well as the entire body. It is highly flexible and is why blood flows out of the heart into the rest of the body. It has three leaflets.

• The pulmonary valve has the primary function of allowing smooth blood flow from the right ventricle into the pulmonary artery. It has three leaflets.

What Causes Valvular Heart Disease?

Valvular heart disease develops due to various underlying factors that may not have been diagnosed and treated on time. There are many reasons for valvular heart disease in individuals ranging from congenital disabilities to age-related changes.

Mentioned below are some of the causes of valvular heart disease.

• Rheumatic heart disease.

• Endocarditis is an infection of the lining present within the heart.

• Intravenous drug.

• Untreated, long-standing infection of the heart.

• Degenerative changes.

• Infection of the blood.

• Congenital heart valve disease.

• Myocardial infarction.

• Heart failure.

• Atherosclerosis.

• Thoracic aortic aneurysm.

• High blood pressure.

• Lupus.

• Marfan syndrome.

• Exposure to high doses.

• Autoimmune conditions.

• Age.

• Valve ring dilatation.

• Syphilis aortitis.

• Traumatic valve rupture.

• Trauma to the papillary muscle.

• Senile degenrative alterations.

• Connective tissues disorders.

• Atrial fibrillation.

• Mitral valve prolapse.

• Mitral annular calcification.

• Malignant carcinoid.

• Iatrogenic pacer-led implantation.

• Right ventricular biopsy.

• Chronic right ventricular pacing.

What Are the Signs and Symptoms of Valvular Heart Disease?

The development of valvular heart disease may happen in a short span of time or may even take years. Depending on the time of onset, clinical manifestations vary accordingly. Once the condition is quite advanced, there are some signs and symptoms that a patient may present with.

Mentioned below are a few of them.

• Shortness of breath.

• Chest pain.

• Fatigue.

• Dizziness.

• Fainting.

• Fever.

• Rapid weight gain.

• Irregular heartbeat.

• Fluttering sensation in the chest.

• Lightheadedness.

• Coughing.

• Swollen ankles.

• Bloating of the abdomen.

• Tightness in the chest.

• Difficulty sitting up.

• Insomnia.

• Inability to engage in physical activities.

• Tiredness after a short distance walk.

• Heavy breathing after and while climbing stairs.

• Heart murmurs.

• Enlargement of the liver.

• Palpitations.

• Swelling of the feet.

• High or low blood pressure depends on the affected valve.

What Are the Types of Valvular Heart Disease?

Valvular heart disease is diagnosed when there is a disruptive change in one or more than one valves of the heart. This change brings about an overall reduction in cardiac input.

Mentioned below are the various types of valvular heart diseases.

• Mitral valve stenosis.

• Mitral valve regurgitation.

• Aortic valve stenosis.

• Aortic valve regurgitation.

• Tricuspid valve stenosis.

• Tricuspid valve regurgitation.

• Pulmonary valve stenosis.

• Pulmonary valve regurgitation.

How Is Valvular Heart Disease Diagnosed?

Valvular heart disease may be diagnosed during a regular consultation with a physician after a few extra diagnostic tests. A stethoscope can pick up any abnormal heart murmurs and regurgitation sounds. To confirm the presence of valvular regurgitation or valvular stenosis, additional tests such as those mentioned below may be suggested. Physical examination and a detailed account of medical as well as drug history are vital for the diagnosis of valvular heart disease.

• Electrocardiography.

• Ultrasound of the heart.

• Complete blood picture.

• Doppler echocardiography.

• X-ray of the chest.

• Transesophageal echocardiogram.

• Magnetic resonance imaging of the heart.

• Catheterization.

How Is Valvular Heart Disease Treated?

The treatment of valvular heart disease or any other cardiovascular disease generally depends on the severity of the condition. Therefore, there are choices of both noninvasive as well as invasive approaches today. Considering the clinical manifestations and the results of the diagnostic tools, the healthcare provider will discuss the preferred treatment modality with the patient and family.

Below are several of the treatment modalities for valvular heart disease.

• Vasodilator therapy.

• Diuretics or water pills.

• Beta-blockers.

• Endocarditis prophylaxis.

• Anticoagulation.

• Open heart surgery.

• Mechanical valve insertion.

• Bioprosthetic valve repair.

• Mitraclip.

• Balloon valvuloplasty.

• Transcatheter aortic valve replacement or TAVR.

• Transcatheter Mitral Valve Replacement or TMVR.

• Cardiac rehabilitation.

Conclusion

The heart has four chambers. The two upper sections are called the left and right atrium, and the lower sections are called the left ventricle and the right ventricle. There are four valves at the tip of each chamber that function to maintain a one-way uninterrupted flow of blood through the heart to the lungs and the entire body. There are many individuals who have suffered from valvular heart disease and, post-treatment, lead an everyday life. Cardiac rehab is one treatment option that includes personalized exercise and patient education to help recover from valvular heart disease. It helps regain cardiovascular strength and minimizes the risk of valvular heart disease in the future. Living a healthy life by including a heart-smart and low-sodium diet with regular physical activity is key to keeping cardiovascular disease at bay.