What is valvular heart disease?
Your heart has four valves. They open and close to keep blood flowing into and out of the heart. The valves keep blood flowing in one direction. They open so that blood can be pumped out, then shut to keep it from coming back in.
Typically (but not always), heart disease involves one of two main problems: stenosis or regurgitation. Stenosis is when the valve narrows, which causes less blood to pump overall. is when the valve leaks in the wrong direction. As in letting blood back into the heart instead of sending it out.
Some people are born with valvular heart disease. Others develop it as they age. Or as a result of a bloodstream infection, heart attack, or congestive heart failure.
Typically people take medications to treat the symptoms, though some may need surgery to repair or replace the valves.
What are the symptoms of a heart valve problem?
Any of these symptoms would concern me enough to order an echocardiogram—slowly worsening shortness of breath, trouble sleeping flat, swelling in legs or belly, chest pain, feelings of lightheadedness or dizziness, or actually passing out. In an asymptomatic person, the valve disease is often picked up on echocardiogram after a doctor hears a murmur. —Dr. Jay Patel
Some people with valvular heart disease don’t have any symptoms. It is diagnosed while your doctor is listening to your heart as part of a regular exam and notices an unusual sound (heart murmur) when they listen.
The most common sign of a valve issue is feeling short of breath. When blood flows backwards from the heart to the lungs, the rest of your body isn’t getting the blood supply it needs. This feeling can be worse when you exercise—or even while just walking around.
Other symptoms include chest pain, lightheadedness, and loss of consciousness (passing out). However, these symptoms can also be caused by other heart conditions, such as a heart attack, arrhythmia (abnormal heartbeat), and . A doctor can tell which condition you have from imaging tests, such as an echocardiogram (ultrasound of your heart).
- Shortness of breath, usually worse when moving around or lying flat
- Chest pain, usually worse when moving around or exercising
- Feeling lightheaded or dizzy
- Suddenly losing consciousness (passing out)
- Leg swelling from blood backing up in the veins
Other symptoms you may have
- Trouble swallowing
- Hoarse voice
- Abdominal swelling
- Abdominal pain
What causes valvular heart disease?
If a heart valve doesn't close all the way, blood can flow backwards, so the rest of your body isn't getting enough blood supply or oxygen. Or, the opening of the valve can become narrow and stiff, allowing less blood to pass through.
There are many conditions that can cause the valves to not function correctly. Narrowing of the aortic valve (aortic stenosis) on the left side of the heart is the most common cause of valvular heart disease in older patients. A few other common causes are:
- Congenital, or present at birth
- Rheumatic fever in childhood
- Bloodstream infections
- High blood pressure
- Heart attack
- Congestive heart failure
- Older age
If you are experiencing symptoms, make an appointment with your doctor or go to the nearest emergency room, as the symptoms can overlap with those of a heart attack. They will use a stethoscope to listen to your heart. If they hear an unusual sound, called a murmur, they may suggest performing an echocardiogram, or an ultrasound of your heart.
The images give your doctor important information about how the heart is pumping and the structure of your valves. If there are abnormalities on this test, your doctor should refer you to a cardiologist. Usually, even people who aren’t yet having symptoms will still need treatment.
Valvular heart disease treatment
People often think that valve disease must be treated with open heart surgery. Certain valvular disease can now be treated through a minimally invasive technique called transcatheter valve repair or replacement. Patients often feel significantly better and back to moving around within days! —Dr. Patel
Treatment for valvular heart disease depends on which type you have and which valve is affected.
Generally, treatment involves prescription medication. Diuretics (often referred to as water pills) will help get rid of any excess water that builds up, which can be a consequence of a leaky or stiff valve.
Blood pressure medication will help lower the stress on your valves by allowing blood to pump more freely through the circulatory system. Your doctor might also give you a blood thinner to lower the risk of stroke. The increased risk of stroke results from slower blood flow through the heart.
Almost everyone with valvular heart disease will eventually need valve surgery to repair or replace the damaged valve. Depending on which valve is damaged, this can be done surgically or percutaneously, which is a newer, minimally invasive technique.
Once you are diagnosed with valvular heart disease, you should continue seeing a cardiologist (heart specialist) regularly. They will likely order echocardiograms from time to time to track whether your disease is getting better or worse. And help treat any symptoms that come up. They will advise you about any potential need for surgical valve repair or replacement down the line.
Valvular heart disease in children
Valvular heart disease can also occur in children.
In newborns, congenital valvular disease symptoms might be blue lips or skin (cyanosis). It is because the infant is not getting enough oxygen, not growing at a normal pace, and is having trouble breathing.
If a child gets rheumatic fever (can happen after untreated strep throat) and isn’t given antibiotics, they’re more likely to develop valvular heart disease in the future.
Is valvular heart disease curable?
Valve disease is a mechanical problem. Medications can be used to help alleviate symptoms, but if it continues to get worse than some kind of procedure must be performed as a solution. —Dr. Patel
While there isn't a cure for valvular heart disease, certain healthy habits can go a long way to preventing it. Especially if you’ve already had a heart attack, have high blood pressure, or have congestive heart failure.
- Don't smoke.
- No more than two alcoholic drinks a day.
- Exercise regularly (ideally 150 minutes a week).
- Eat less salt. For adults, 2,000 milligrams (mg) is a good upper limit for daily intake.
- Treat and control conditions like high blood pressure, high cholesterol, and diabetes.
- Treat strep throat infections quickly in children. This can prevent rheumatic fever from developing.
There are several different types of valvular heart disease, and each has its own specifics when it comes to surveillance, possibility for medical management, and indications for intervention. It is really important to discuss with a cardiologist what type of valve disease one has and how to best treat it.