Heart Valve Disease

Causes of heart valve disease

Heart valve disease occurs when the heart’s valves do not work properly. The heart has four valves, the mitral valve, tricuspid valve, pulmonary valve, or aortic valve, which are responsible for ensuring blood flows in the right direction. If a valve is not working correctly, blood flow can be disrupted.

Heart valve disease can be present at birth or develop as a normal part of aging. Other causes for heart valve disease including:

• Damage from a heart attack or rheumatic fever.
• Damage from rheumatic fever.
• The buildup of calcium on the valve.
• Infection in the heart walls or valves.

Risk factors of heart valve disease

Heart valve disease can affect anyone, but there are a variety of risk factors that increase your likelihood of developing heart valve disease, including:

• Age. Older people are more likely to experience heart valve problems. As a person ages, your valves can become thicker and stiffer as calcium deposits build up on the valves. As the calcium builds up, the valves may not open and close as they should.
• Co-existing heart conditions. If you have had a previous heart attack or have heart failure, it can affect how your valves function.
• Endocarditis (infection of the endocardium). Endocarditis can be effectively treated with antibiotics but can affect your heart valve later in life.
• Rheumatic fever. Rheumatic fever can permanently damage your heart muscle and heart valves. Heart valve disease symptoms may not appear until more than ten years after you recover from rheumatic fever.
• High blood pressure. Uncontrolled high blood pressure can cause your heart or main arteries to enlarge, which affects the heart valves.
• Radiation therapy. People who have radiation therapy in the chest area are more likely to develop heart valve disease later in life.
• Smoking. Chemicals from tobacco can affect how your heart valves and blood vessels work.

Symptoms of heart valve disease

The most common sign of heart valve disease is shortness of breath after minimal physical activity.

Other common signs of heart valve disease include:

• Swelling in the feet, ankles, hands, or abdomen.
• Irregular heartbeat.
• Chest pain or discomfort.
• Fatigue.
• Dizziness or fainting.
• Fever.
• Weight gain.

Some people may not notice symptoms of heart valve disease if their condition has progressed slowly over time.

Complications of heart valve disease

Heart valve disease can lead to severe complications such as heart failure, stroke, blood clots, arrhythmias, or sudden death. If you experience heart valve disease symptoms, schedule an appointment with your cardiologist right away.

Diagnosing heart valve disease

Your primary care or heart doctor can diagnose heart valve disease. During a physical exam, your doctor will listen for heart murmurs, an indicator of heart valve disease. Your doctor will also take a full medical history and order diagnostic tests such as:

• Echocardiogram (Echo). An Echo is the primary imaging test used to diagnose heart valve disease. Your doctor can determine if you have a narrowed heart valve and how well your heart pumps blood by reviewing the test results.
• Electrocardiogram (ECG or EKG). An EKG measures the heart’s electrical activity, heart muscle thickening, and heart muscle damage from coronary artery disease.
• Stress test (treadmill test). During a treadmill test, your doctor can measure your heart’s electrical activity while you exercise on a treadmill or stationary bike.
• Chest X-rays. A chest X-ray will reveal if you have fluid in your lungs. It can also show if you have calcium deposits in the lungs or heart.
• Cardiac catheterization (cardiac cath). A cardiac cath can be used to determine if you have pressure irregularities across the heart valves or to determine if your blood is flowing backward through the valves.

Treatment for heart valve disease

Heart valve disease treatment goals are to protect the heart from further damage and repair or replace a valve if needed.

Your doctor may recommend lifestyle changes, monitoring, or medical management as first-line therapy to treat heart valve disease. If your symptoms are affecting your day-to-day activity level, surgery may be necessary.

Surgical options to treat heart valve disease include:

• Heart valve repair. Heart valve repair is performed on patients who have been diagnosed with mitral valve insufficiency or tricuspid valve insufficiency. Your cardiac surgeon will separate the valve flaps during valve repair surgery, remove any unnecessary tissues, or patch a hole in the valve. Heart valve repair can be minor surgery or more extensive based on the severity of your condition.
• Valve replacement. Valve replacement surgery is necessary when the valve cannot be repaired. It can be performed via open-heart surgery or through a minimally invasive procedure such as transcatheter aortic valve replacement. During the surgery, your cardiac surgeon will remove the damaged valve and replace it with a tissue valve, biological valve, or mechanical valve.

When to Seek Care

If you feel a heart murmur, schedule an appointment with your doctor.

If you are having chest pain, lose consciousness, or have trouble breathing, seek immediate medical care.