Heart
Valve
Disease
What is heart valve disease?

Heart valve disease is the name given to any malfunction or abnormality of one or more of the heart’s four valves, affecting blood flow through the heart. The condition is usually caused by wear, disease, or damage of one or more of the heart’s valves.

The heart has four chambers that pump blood around the body. There are a series of valves in the heart that, when working properly, ensure blood flows in the right direction through the heart’s chambers, which are closed off by a one-way valve. Diseased or defective heart valves – those that have become narrowed (stenosis), leaky (regurgitation), or both – may not open or close properly and can interfere with the flow of blood.

The primary types of heart valve disease are:

  • Valve Stenosis or Obstruction: As a result of certain medical conditions or anatomical abnormalities, a valve can either be exceptionally narrow, known as having a stenosis, or have a blockage or obstruction. Either of these conditions can limit the blood flow through the valve, which may result in a “back-up” of blood behind the valve and cause the heart to pump inefficiently or build up blood pressure in the lungs. This condition is often due to age-related hardening (calcification) of the aortic valve leading to progressive narrowing and is most commonly associated with aortic stenosis or mitral stenosis.
  • Valve Regurgitation or Insufficiency: When a valve fails to fully close, the valve itself can become “leaky”, allowing blood to backwash down through the valve, known as regurgitation. In addition, the valve may not ever completely move the volume of blood to the next appropriate chamber. This condition includes mitral regurgitation and aortic regurgitation.
Signs and Symptoms

The signs of heart valve disease include, but are not limited to:

  • Shortness of breath
  • Fainting
  • Coughing
  • Chest tightness and/or pain
  • Fatigue
  • Light-headedness or dizziness
  • Abnormal heart rhythm sensations (i.e. irregular heart beat)

These symptoms are not always severe or visible, and are often seen as a part of the natural aging process, meaning the symptoms are classified as ‘asymptomatic’. They are also similar to symptoms of other forms of heart disease and lung-related problems.

Diagnosis

Heart valve disease is a treatable condition if diagnosed early. Diagnosing heart valve disease starts with a simple stethoscope check. Your doctor will use a stethoscope to listen to your heart for the characteristic heart “murmur” or “click-murmur” that is usually the first indication of a heart valve disorder. After that initial diagnosis, a more sophisticated investigation with either an echocardiogram or another form of heart scan can be undertaken to understand the exact type of heart valve disease and the severity of the abnormality.

If you are over 65 or think you may have any of the symptoms of heart valve disease, please see your primary care physician.

Treatment

During the early stages of heart valve disease, when it is less severe and not causing significant symptoms or issues, it may be best to simply monitor your condition to see how things develop. However, the earlier the diagnosis and treatment of heart valve disease, the better the patient prognosis. Therefore, it is very important to ensure regular monitoring of your symptoms with your doctor so that any deterioration or change is recognized quickly and can be treated appropriately.

Treatment for heart valve disease varies according to the severity of the disease, but generally requires either valve repair or replacement through surgery. In some cases, the aortic valve can be repaired during surgery and the patient’s tissue maintained. More often however, aortic valve replacement is required using either a mechanical valve or a tissue valve from an animal. Mitral valves are more commonly treated with repair procedures, but can also require a valve replacement.

Traditional heart valve surgery has proven to be an effective method for repair and replacement for more than 50 years. In addition to the more traditional forms of open heart surgery, there are also more innovative and less invasive approaches available today, such as the transcatheter aortic valve implementation (TAVI) procedure. These types of treatments may be suitable for patients who are at higher risk for the more traditional forms of surgery. Your doctor will be able to advise on the most appropriate treatment for you.