Heart Valve Disease

What do Heart Valves Do?

The four valves in your heart are made of thin (but strong) flaps of tissues that open and close as your heart pumps. They are there to make sure that blood flows through your heart the right was. Your valves work hard as they stretch back and forth with every heartbeat.  
 
Your heart has four chambers. Each chamber has a valve that acts like a door. The four valves open and close as they keep blood flowing through your heart the right way.

What are Valve Problems?

• Don't open enough; called stenosis.
• Don't let enough blood flow through; also called stenosis.
• Don't close properly and let blood leak where it shouldn't. This is called incompetence, insufficiency or regurgitation.
• Make heart work too hard and lead to heart failure.
• Prolapse. Mitral valve flaps don't close properly (more common in women). As pressure builds inside the left ventricle, it pushes the mitral valve flap back into the left atrium, which may cause a small leak.

What Causes Valve Problems?

• A small birth defect that's not repaired may get worse later in life and cause problems.
• Certain diseases can scar or destroy a valve.
• Aging can make valves weaken or harden.

Symptoms of Heart Valve Disease

Symptoms of heart valve disease may include:

• Wheezing, coughing or shortness of breath when you exert yourself
• Problems breathing when lying down; waking up at night coughing or feeling short of breath
• Swollen ankles or feet
• Weakness or tiredness
• Chest pain or pressure
• Fast, pounding heartbeat or fluttering feeling in your chest
• Dizzy spells or fainting spells

Which Valves are Affected?

• Any valve can develop a problem. But problems are most common with the aortic and mitral valves.
• Problems with the tricuspid or pulmonic valves are less common than problems with either the aortic or mitral valves.

Aortic Stenosis

Aortic Stenosis means the aortic valve has a problem opening.

The possible causes of aortic stenosis are: deposits can form on the aortic valve as you get older which can make the valve stiff and hard to open, sometimes people can be born with a problem aortic valve, or the aortic valve may be damaged by rheumatic fever.

Aortic Insufficiency

Aortic insufficiency means your aortic valve has problems closing. Blood leaks back through the valve.

The possible causes of aortic insufficiency are: you may be born with a problem aortic valve that doesn't close properly or the aortic valve can be damaged by rheumatic fever or a heart infection.

Mitral Valve Prolapse

With this valve problem, the mitral valve flaps don't close properly, the valve bulges slightly back into the atrium, which may cause a small leak.

Minor symptoms such as mild chest pain or palpitations may occur.

In some cases mitral valve prolapse can progress to serious mitral insufficiency.

Mitral valve prolapse is often present from birth. Sometimes mitral valve prolapse may develop later in life due to wear and tear.

Mitral valve prolapse may be inherited and is more common in women than in men.

Mitral valve prolapse does not usually need treatment unless the symptoms are severe.

Mitral Valve Insufficiency

Mitral insufficiency means your mitral valve has problems closing, letting blood leak back through the valve.

Severe cases of mitral insufficiency can lead to damage to the ventricle and heart muscle.

The possible causes of Mitral insufficiency are: damage caused by rheumatic fever, aging or from mitral valve prolapse.

Mitral Stenosis

Mitral stenosis means the mitral valve stiffens and does not open right, therefore blood must move through a smaller opening. Fluid can build up in the lungs, which can lead to coughing and breathing problems.

Problems with the mitral valve can also cause a fast or irregular heartbeat.

One of the possible causes of mitral stenosis is rheumatic fever, which can lead to an inflammation that damages the heart valve.

Women may first develop symptoms of mitral stenosis during pregnancy because the amount of blood the heart has to move has increased.

Tricuspid and Pulmonic Valve Problems

Problems with the tricuspid and pulmonic valves are less common that problems with the aortic or mitral valves.

Tricuspid insufficiency is generally caused by another heart or lung problem.

Tricuspid stenosis is rare and most often due to rheumatic fever.

Pulmonic disease is congenital. Pulmonic valve disease is often not found until tests are done on the heart for other reasons.

Tricuspid or pulmonic valve problems usually do not need treatment.

Medications may be prescribed to relieve symptoms if they are present.

What can be done?

• Treatment depends on which type of valve disease you have and how severe it is.
• Yearly checkups with your doctor, medicine and living a healthy lifestyle may be all that's needed.
• In some cases, an operation may be needed to repair a damaged valve.
• Sometimes the valve must be taken out and replaced with a new, artificial one. Ask your doctor about the different kinds.

Treating Valve Disease with Medications

Medications can be used to ease symptoms of valve disease and to help prevent problems that may occur due to valve disease.

The medications that may be prescribed to treat the symptoms are:

Diuretics help rid the body of excess fluid. Less fluid to pump makes the heart's job easier. Getting rid of extra water can also help decrease swelling, bloating and shortness of breath.

Digitalis helps the heart pump with more strength, allowing the heart to pump more blood with each beat. It may also help keep the heartbeat regular.

ACE Inhibitors relax blood vessels and lower blood pressure. By relaxing blood vessels and lowering blood pressure, blood flow more easily, and the heart does not have to work as hard to pump the same amount of blood.

Beta-blockers slow the heart rate. By slowing the heart rate, the work the heart has to do is lessened.

Antiarrhythmics control a fast or irregular heartbeat.

Problems with heart valves can make the heart more likely to form blood clots or become infected.

Anticoagulants prevent blood clots from forming inside the heart chambers or on a damaged heart valve.

Antibiotics help prevent infection due to bacteria that can stick to abnormal heart valves. You doctor may have you take them before certain procedures including dental work. If you have a valve problem, ask your doctor before having any procedure.

Treating Valve Disease with Surgery

A problem heart valve can be repaired or replaced with surgery. Repair means the valve is fixed to work better. Replacement means the diseased valve is removed and a new one is put in its place. Replacement valves can be mechanical or biological. With mechanical valves, lifetime therapy with anticoagulant medications is needed because blood clots can form on these valves. With biological valves (valves which are taken from pig, cow or human donors) long-term anticoagulant therapy may not be needed.

How can I Learn More?

Talk to your doctor, nurse or health care professional.
If you have heart disease, members of your family also may be at higher risk. It's very important for them to make changes now to lower their risk.

Disclaimer
Reviewed by Alberta clinical experts. Brought to you by HealthLink Alberta. Copyright.
This material is designed for information purposes only. It should not be used in place of medical advice, instruction and/or treatment. For more health advice call Capital Health Link at 780-408-LINK (5465) 24 hours a day, seven days a week. In Alberta, call Toll-free: 1-866-408-LINK (5465)