What You Should Know About Heart Valve Disease

Your heart has four valves. Their job is to make sure that blood flows properly and in the right direction. The valves have flaps that act like trap doors. They open and close with each heartbeat to allow blood to flow through. Heart valve disease is a condition in which one or more of the valves isn't working properly.

As with any medical condition, learning about it helps you become more involved in your medical care and treatment. Start with these facts about heart valve disease.

Problems Involving Heart Valves

Several problems can affect your heart valves:

• A valve may have an abnormal shape. Or, it may be missing the opening that blood should flow through (atresia).

• A valve might not close properly. It bulges or flops back during a heartbeat: That’s prolapse.

• Blood might leak backwards through a valve: That's regurgitation.

• A valve could be too narrow, thick or stiff to open fully. That means less blood can flow through. The name for this valve problem is stenosis.

If you have heart valve disease, your heart has to work harder than usual to pump. Because of this, it might not pump blood as well as it should and your body does not get the amount of freshly oxygenated blood and nutrients it needs.

Common Causes of Heart Valve Disease

Several things can cause heart valve disease. Some people are born with birth defects that affect their heart valves. It’s not clear why this happens.

Also, the shape and flexibility of healthy valves could change because of:

• Changes that occur as you age
• Advanced heart disease from high blood pressure, heart failure, or hardening of the arteries
• Scar tissue from a heart attack
• Infections like rheumatic fever and inflammation of the inner layer of heart tissue (infective endocarditis)
• Injury

People at Risk of Developing Heart Valve Disease

Heart valve disease is more likely if you:

• Have conditions that increase your risk of heart disease, such as high blood pressure
• Are older
• Are overweight or obese
• Have diabetes
• Have heart failure
• Have had a heart attack
• Smoke
• Use IV drugs because this increases infection risk
• Have had infective endocarditis or rheumatic fever

Symptoms of Valve Disease

An abnormal heartbeat sound called a heart murmur is the main warning sign of heart valve disease. A doctor or other medical professional can hear heart murmurs with a stethoscope. Many people with mild heart valve problems have no symptoms that they can notice on their own. But, after several years with heart valve disease, some symptoms may become noticeable, including:

• A fluttering or racing sensation in the heart
• Chest pain
• Dizziness
• Extreme tiredness
• Fainting
• Shortness of breath, even when lying down
• Swelling in the ankles, legs, feet, belly or neck veins

Diagnosing Heart Valve Disease

Your doctor may first suspect a problem if he or she hears a murmur when listening to your heart with a stethoscope during an exam. Your doctor will also listen to your lungs and check your feet and ankles for signs of swelling.

You may have some tests that help diagnose heart valve disease:

• Echocardiography. Sound waves create a picture of your beating heart. It shows how well your heart is pumping. It also shows the size and shape of your heart valves.
• Electrocardiogram (EKG). This test checks your heart's electrical activity. It can show if you have an irregular heartbeat or if you had a heart attack in the past.
• Chest X-ray. This image can show if there is fluid backing up into your lungs from a heart valve defect. It also can show if your heart is too big (enlarged heart).

Other tests help determine how severe a valve problem is and the right type of treatment:

• Cardiac catheterization. Your doctor guides a long, thin tube (catheter) through a blood vessel to your heart. This test can show if blood is flowing in the wrong direction or if a valve isn’t opening fully. Doctors also can perform certain heart valve treatments during cardiac catheterization.
• Stress test. This test takes pictures of your heart while it’s working hard.
• MRI. This test creates detailed images of your heart that can reveal problems with the valves.

Treatments for Heart Valve Disease

Mild heart valve problems might not affect your quality of life. More serious heart valve disease can lead to heart failure, blood clots, and stroke.

There are no medicines that can fix a damaged heart valve. However, there are drugs to ease symptoms and help manage health issues that put added stress on your heart. These include drugs that:

• Lower blood pressure
• Lower cholesterol
• Prevent irregular heartbeats
• Thin your blood and prevent clots
• Widen blood vessels
• Get rid of extra fluid

Damaged heart valves that impair the heart’s ability to pump blood may need surgery to repair or replace them. Heart valve surgery includes repair and replacement:

• Valve repair: A surgeon fixes holes or tears in the valve or reshapes it so that it opens and closes properly.

   

• Valve replacement: A surgeon removes the defective valve and replaces it with an artificial valve or a valve made with pig, cow or human heart tissue.