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Valvular heart disease

What is Valvular heart disease?

Valvular heart disease refers to the disease of the heart valves. Heart valves act like doors to control the blood flow between the different parts of the heart. Valvular heart disease affects one or more heart valves, which then become damaged and do not function properly. Different valvular heart diseases involve different valves, and certain diseases can affect more than one valve.

Valve diseases can consist of congenital abnormalities (present at birth), or can be acquired later in life as a result of infection or degeneration.

There are 2 major types of valvular heart disease:

  • Valvular insufficiency, which occurs when the valve does not close tightly enough and causes backflow
  • Valvular stenosis, which occurs when the opening of the valve is smaller than normal, reducing the amount of blood that flows through

Causes

There are many causes that can lead to valvular heart disease:

  • Congenital (present at birth)
  • Degeneration of valve tissues with age
  • Drugs (migraine medication, diet pills) and radiation therapy (cancer treatment)
  • Heart attack, atherosclerosis (build-up of fatty deposits in arteries), and high blood pressure
  • Infections including rheumatic fever and infective endocarditis

Symptoms

Initially, you may not present with any symptoms even if the damage to your affected valve is severe. However, the symptoms can progress to include:

  • Fainting
  • Fatigue
  • Irregular heart beats
  • Shortness of breath on exertion
  • Swollen ankles

Treatment

Different treatments are available for different valvular heart diseases, depending on the valves involved and the severity of the damage. The treatments include:

–  Medication – it is important that regular follow-up is maintained to prevent recurrence

–  Balloon valvuloplasty is recommended for patients whose valves are narrowed. A tiny balloon catheter is directed to the target valve, which is inflated and deflated several times, until the valve opening is widened sufficiently.

–  Surgery may be needed when multiple valves are severely damaged and you may be referred to one of our interventional cardiologists or a cardiac surgeon:

  • Valve repairs can result in fast recovery from surgery, very good survival rates and may not need life-long medical therapy, whilst maintaining your original valves
  • Valve replacementis usually performed for more complex cases and where the valves are severely damaged. This can be a minimally invasive approach where the old valve is replaced with a new one.

Chambers and valves of the heart

A normal heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood out of your heart. The heart valves, which keep blood flowing in the right direction, are gates at the chamber openings.

A normal heart and heart valve problems

Heart valve problems may include a narrowed valve (stenosis), a leaking valve (regurgitation) or a valve with leaflets that are bulging back (prolapse), as shown in the bottom two images. A normal heart and valves is shown in the top image.

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