Valvular heart disease refers to a disease that affects at least one or more of the heart’s valves. The heart is comprised of four types of valves: the pulmonary and tricuspid valves on the left and the aortic and mitral valves on the right. The valves which are located at the exit point of each heart chamber ensures that the blood flows in one direction by opening and closing the chambers as the blood flows through each chamber. When the valves do not function as they should this may result in the leakage of blood backwards which in turn, disrupts cardiovascular circulation.
Valvular insufficiency
This occurs when the valve is unable to close properly causing leakage of the blood backwards. It is also known as regurgitation, leaky valve or incompetence. As the condition becomes more severe the heart is forced to pump more strongly to enable an adequate supply of blood to the body. However the blood supply going to the body will be significantly compromised as will the heart which has to exert more energy to fulfil the body’s needs. The type of valvular insufficiency will be labelled in accordance with the valve that it affects thus the terms: pulmonary regurgitation, tricuspid regurgitation, aortic regurgitation or mitral regurgitation are applied categorically.
Valvular Stenosis
Refers to the condition in which a valve opening has narrowed considerably. This narrowing causes the heart to pump the blood through the valve more vigorously which eventually weakens the heart and may cause heart failure or other symptoms associated with this condition. It may affect any of the four valves present within the chambers of the heart. Therefore, the affected valve is specified in reference to the disease as follows: pulmonic stenosis, mitral stenosis, aortic stenosis or tricuspid stenosis.
Causes of Valvular Heart Disease
Valvular disease may be as a result of a congenital defect (before birth) or may develop over the course of a lifetime. The direct cause of the disease is not always ascertained in some instances.
Acquired Valve Disease
This is specific to abnormalities that affect once functioning valves. The alteration to the proper functioning of the valve may be the result of any number of diseases or infections. Two prominent diseases that may induce valvular dysfunction are rheumatic heart disease or endocarditis.
Rheumatic fever develops because of an untreated bacterial infection most commonly from the streptococcal bacteria. If treated by antibiotics the likelihood of developing a related heart disease is lessened. If, however, the disease is left untreated it may lead to the inflammation, thickening and shortening of the valves and is generally associated with mitral regurgitation.
Endocarditis usually manifests when the bloodstream is infected by pathogens like bacteria that attack the heart valves resulting in subsequent damage to the valves. The pathogens enter the bloodstream during dental surgery, after a bout of serious infection or through intravenous drug use.
The valve may be altered in several different ways which may include: dilation of the annulus, the tearing and stretching of the papillary or chordae tendinea muscles or calcification and stiffening of the valve leaflets.
Other diseases may also induce valvular disease including but not limited to: heart attack, syphilis and other sexually transmitted infections, cardipmyopathy and hypertension among others.
Congenital Valve Disease
In the congenital forms of the disease it is likely for the aortic and pulmonic valve to be affected. The valves may have malformed leaflets, be incorrectly sized or may have leaflets that are improperly connected to the annulus.
Bicuspid aortic valve disease is a notable congenital valve disease and results in the development of only two leaflets in the bicuspid aortic valve. This leads to stiffness of or leaking from the valve.
Symptoms of Valve Disease
As with all symptoms associated with any disease it is possible for them to closely resemble those of other diseases. Therefore it is still essential to be assessed by a medical doctor to discern their underlying cause.
Shortness of breath
Shortness of breath is characterized by any difficulty experienced when attempting to breathe normally. This symptom usually manifests itself after performing physical activity and is often worsened by over- exertion. It may also occur when lying down on the back while resting or sleeping. Most people who are affected by this symptom realize that they need to sleep with two or more pillows to breathe comfortably at night. This symptom may also be attributed to a pulmonary condition.
Palpitations
Palpitations are often described as an abnormal awareness of the beating heart. The feeling will often be accompanied by what is expressed as irregular heartbeats or the sensation of skipping heartbeats.
Chest Discomfort
Feeling pressure within the chest cavity especially when exposed to cold air is a symptom that is often associated with heart disease in general. However this may also be as a result of a digestive disorder, pancreatitis or any other condition that causes similar chest pain.
Weakness or dizziness
A bout of dizziness or sudden weakness that may affect regular activity may be experienced with this and many other types of conditions that may include dehydration, anaemia, viral infection and pregnancy. It is also quite possible to faint as a result of dizziness.
Swelling of limbs and abdomen
This type of swelling results from fluid retention due to poor circulation and is refered to as oedema. It usually affects the feet and ankles but may also be present in the abdomen. This type of swelling does not necessarily denote the presence of a serious condition and may be as the result of natural ageing, sitting in a particular position for a prolonged period or pregnancy. However in most cases it is still advisable to be medically assesed to rule out any other possible life threatening complications.
Sudden and Rapid Weight Gain
Gaining as much as three pounds daily or more may also be a probable sign of this disease. However weight gain be as a direct result of over eating or a thyroid condition, specifically hypothyroidism.
Diagnosing and Treating Valvular Heart Disease
To diagnose the condition the medical practitioner will perform an initial physical examination. Once this is done other tests will be introduced to ensure that a condition may be detected before it escalates. Typical diagnostic tests that will be performed include echocardiography, cardiac catherization, radionuclide scan, MRI magnetic resonance imaging and transesophageal echocardiography. Once a diagnosis is made it will be important to manage and treat the disease as necessary.
Treatment for valvular disease will include: surgery to repair or replace the valve if at all possible; the administering of medications to lessen the severity of the disease; and antibiotic treatment to reduce the chance of developing any infections.
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