What Is Heart Valve Disease?
When one or more heart valves don’t function properly, you have what’s known as “heart valve disease.” To understand the disease, it helps to know how the valves work.
The heart has four valves: the tricuspid, pulmonary, mitral, and aortic valves. Each valve has tissue flaps that open and close when your heart beats. These flaps ensure that blood flows in the right direction through the heart’s chambers – then throughout your body.
Birth defects, infections, age-related changes, and other conditions can affect a heart valve’s function. The valve might not open fully, or the valve may let blood get back into the heart chambers. When this happens, your heart must work harder – and its blood-pumping ability becomes limited.
Understanding Heart Valve Problems
Heart valves can have three basic problems: regurgitation, stenosis, and atresia.
- Regurgitation, aka backflow, occurs if a valve fails to close tightly. This allows blood to leak back into the heart chambers. When the valve functions properly, blood flows forward through the heart or into an artery. Backflow is often caused by prolapse. "Prolapse" is a condition when the valve’s flaps flop (or bulge) into an upper heart chamber during a heartbeat. Prolapse mainly affects the mitral valve.
- Stenosis occurs if the valve’s flaps stiffen, thicken, or bond together. The heart valve cannot be fully open. As a result, not enough blood flows through the valve. Some valves will have both stenosis and backflow problems.
- Atresia occurs if a heart valve lacks an opening for blood to pass through.
What Causes Heart Valve Disease?
Some people are born with heart valve disease, which is called congenital heart valve disease. Congenital heart valve disease can occur alone or may develop along with other congenital heart defects.
Congenital heart valve disease often occurs when pulmonary or aortic valves don't form properly. These valves may be missing tissue flaps, or the valves may be the wrong size or shape. In some cases, the valve may lack an opening that allows proper blood flow.
Other people acquire heart valve disease later in life. This usually involves the aortic or mitral valves. While the valves are normal at birth, problems develop later on.
Both congenital and acquired heart valve disease can cause stenosis or backflow.
Who Is at Risk for Heart Valve Disease?
As people get older, their risk increases. As the body ages, the heart valves tend to thicken and become stiffer. Because more people are living into old age, the risk of heart valve disease has become an increasing problem.
Your risk is higher if you have a history of infective endocarditis (IE), rheumatic fever, heart attack, or heart failure—or previous heart valve disease. Intravenous drug use also increases the risk of heart valve disease.
If you have coronary heart disease, you also have a higher risk of heart valve disease.
Other risk factors increase your risk of heart valve disease, these factors may include:
- High blood cholesterol
- High blood pressure
- Insulin resistance
- Overweight or obesity
- Lack of physical activity
- A family history of early heart disease
Symptoms of Heart Valve Disease
An unusual heartbeat sound called a heart murmur is the primary symptom of heart valve disease. A doctor will be able to hear a heart murmur with a stethoscope. In some cases, a person can have a heart murmur without having heart valve disease or another heart problem.
Heart valve disease typically gets worse over time, so signs may occur years after a heart murmur is first heard. Many people with heart valve disease don't have any symptoms until they're middle-aged or older.
Coronary artery disease is a type of heart disease that causes a buildup of fatty residue (plaque), in the arteries that supply the blood to the heart.
Symptoms of heart valve disease may also include:
- Unusual fatigue
- Shortness of breath
- Breathing difficulty during physical activity or when resting
- Swelling in ankles, feet, legs, abdomen, and neck veins
- Chest pain (may occur only with physical exertion)
- Racing, irregular or fluttering heartbeat
- Dizziness or fainting
Treatment for Heart Valve Disease
While there is no medicine that cures this disease, lifestyle changes and medications can treat the symptoms effectively – and delay worse problems for many years. Eventually, you may need surgery to repair or replace a faulty heart valve.
Prescription Heart Valve Disease Medications
Prescription medicines may help to:
- Lower high blood pressure or high blood cholesterol.
- Prevent irregular heartbeat (arrhythmia).
- Thin the blood and prevent clots (if you have a man-made replacement valve). Doctors also prescribe these medicines for mitral stenosis or other valve defects that raise the risk of blood clots.
- Treat coronary heart disease to reduce your heart’s workload and relieve symptoms.
- Treat heart failure by widening blood vessels and ridding the body of excess fluid.
Surgery to Repair or Replace Heart Valves
Even if your heart valve disease isn’t causing symptoms, your doctor may advise repairing or replacing your heart valve(s). This can prevent lasting damage to your heart and sudden death.
The decision is based on many factors, including:
- The severity of your valve disease
- Other surgeries needed like bypass surgery to treat coronary heart disease. Bypass surgery and valve surgery can be performed at the same time.
- Your age and general health
Heart valve repair is typically preferred over heart valve replacement. Valve repair preserves the strength and function of the heart muscle. People who have valve repair also have a lower risk of infective endocarditis after the surgery, and they don’t need to take blood-thinning medicines for the rest of their lives.
However, heart valve repair surgery is harder to do than valve replacement. Also, not all valves can be repaired. Mitral valves often can be repaired. Aortic and pulmonary valves often have to be replaced.
Cardiologists can repair heart valves using a less-invasive procedure called cardiac catheterization. However, this doesn’t work well for some patients.
Heart valves that cannot open fully can be repaired with surgery or with a less invasive catheter procedure called balloon valvuloplasty. This procedure also is called balloon valvotomy. Balloon valvuloplasty relieves many symptoms of heart valve disease, but may not cure it.
Practicing Heart Health
Your doctor will closely monitor your condition in follow-up visits. During this time, you will need to adopt a heart-healthy lifestyle. That includes:
- Eating a heart-healthy diet
- Maintaining a healthy weight
- Getting regular physical activity
- Managing stress
- Avoiding tobacco
Having the support of family and friends can help you cope with this condition. Talk to your doctor about support groups that may also be helpful. Follow your doctor’s advice closely, taking medications as prescribed. And stay active; follow the activities that your doctor says are appropriate for you.