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Heart valve disease refers to any malfunction in one or more of the heart’s four valves. These valves are located within the heart and open to allow blood to move forward in one direction, and close to prevent the back-flow of blood.

WHAT IS A VALVE DISORDER?

The human heart has four valves. The tricuspid and pulmonic valves are located on the right side of the heart, while the mitral and aortic valves can be found on the left side. If a valve fails to close properly — called incompetence, insufficiency, or regurgitation — blood can leak back into the prior chamber with each beat. If the valve fails to open properly — called stenosis — then not enough blood moves through the abnormally narrow opening. Either problem can force the heart to work much harder and seriously interfere with its ability to pump blood.

WHAT ARE THE SYMPTOMS?

Some people have none. In fact, a valve disorder may be detected for the first time when a physician listens to the patient’s heart during a routine physical exam and hears a heart murmur.

Depending on the type and severity of the problem, other patients may have symptoms such as chest painpalpitations, migraines, fatigue, dizziness, fainting, and shortness of breath. In addition, when the heart’s left ventricle must pump more blood because of abnormal back-flow from the aortic valve, it gradually enlarges to increase the force of each heartbeat. This may cause congestive heart failure. When the left atrium enlarges to accommodate the extra blood leaking back from the ventricle, it may beat rapidly in an irregular disorganized pattern (atrial fibrillation), which further reduces the heart’s pumping efficiency and increases the risk of blood clots that may cause a stroke.

WHAT CAUSES VALVE DISORDERS?

Until the advent of antibiotics for strep throat, rheumatic fever used to be the most common cause. Today in the United States, they are more commonly caused by such problems as a birth defect, a heart attack, or calcification of the valves.

HOW ARE VALVE PROBLEMS DIAGNOSED?

An electrocardiogram (ECG) and chest X-ray can show left ventricle enlargement. Echocardiography, an imaging technique that uses ultrasound, can show the severity of the problem. Cardiac catheterization may be necessary to determine the extent and characteristics of mitral, tricuspid and aortic value stenosis.

HOW ARE VALVE PROBLEMS TREATED?

Mild valve problems may not need therapy. However, medication can slow the heart rate, reduce blood pressure, and help control palpitations, fibrillation, and other symptoms. (Many people with heart valve problems are advised to take preventive antibiotics before any dental or surgical procedure to reduce the risk of a valve infection.) If drug therapy doesn’t reduce the symptoms satisfactorily, a minimally invasive procedure called valvuloplasty, or surgical valve repair or replacement may be needed.


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