Heart Valve Disease: Information on Causes, Diagnosis & Treatments

Heart Valve Disease Overview

Diagram Heart Valves According to the National Heart, Lung, and Blood Institute, heart valve disease is a condition where the heart valves work inefficiently. The American Heart Association reveals that approximately four million individuals in the United States are diagnosed with heart valve disease every year. There are two different types of heart valve disease including valvular insufficiency and valvular stenosis. The condition can be caused by a variety of factors including bicuspid aortic valve disease, congenital valve disease, and acquired valve disease such as endocarditis and rheumatic fever.

Diagnosing the condition usually requires a comprehensive physical exam and a discussion about common symptoms associated with mild to severe valve disease. Many heart valve disease conditions require extensive treatment to prevent further damage or repair/replace and extensively damaged valve.

Causes

There are numerous factors that can cause heart valve disease including changes associated with aging, rheumatic fever, or infections. These conditions can easily change the flexibility or shape of the heart valve or distort/stretch the valve to the point where it works inefficiently. The most common causes of the development of heart valve disease involve:

  • Heart Conditions – Patients suffering from atherosclerosis in the aorta often have restricted blood flow because of the build-up of plaque inside the arteries that carry oxygenated blood throughout the body. Heart failure and advanced high blood pressure conditions can enlarge the main arteries and heart muscle causing significant damage. In addition, scar tissue caused by a heart attack can also distort the valve or stretch beyond its ability to function normally.

  • Rheumatic Fever – Serious infections including strep throat that go untreated can degrade to rheumatic fever and result in serious life-threatening heart valve disease. The body’s attempt to protect itself against strep infection can cause scarring or damage to heart valves, especially mitral and aortic valves in the heart. In some cases, the damage caused by rheumatic fever does not appear until many years later.

  • Infections – Common microorganisms that enter the body’s bloodstream can easily make its way to the heart muscle and effect its inner structure including heart valves. Though rare, the development of infective endocarditis is a serious condition that can claim the life of the patient. This type of disease usually develops in individuals who are already suffering from abnormal heart valve blood flow caused by an acquired or congenital heart valve disease. Infective endocarditis can cause a significantly worsening problem if heart valve disease already exists.

  • Other Risk Factors and Conditions – Other factors and conditions play a role in the potential risk of developing life-threatening heart valve disease. These factors and conditions include:
    • Autoimmune disorders

    • Diet drugs like Fen/Phen (fenfluramine and phentermine)

    • Carcinoid syndrome involving digestive tract tumors that spread to lymph nodes in the liver and eventually affect pulmonary and tricuspid valves

    • Chest area radiation therapy for the treatment of cancers

    • Metabolic disorders including high blood cholesterol and Fabry disease can cause damage to heart valves

    • Marfan syndrome and other connective tissue/congenital disorders can damage heart valves

If the doctor prescribed antibiotics to treat any infection or rheumatoid fever, it is essential that the patient continue taking all the antibiotic medication as prescribed until the medicine is gone, even if they feel better in the first few days. This is because not completing the antibiotic treatment could allow the dangerous bacteria to become highly resistant while in the body and cause significant damage in the months or years ahead.

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Who Gets Heart Valve Disease?

In most cases, heart valve disease is a condition of the elderly. This is because, during the aging process, the body’s heart valves wear out and become stiff. This is a significant problem compared to humans living a century ago because most men and women now live longer.

Individuals who are most at risk of developing heart valve disease include those with a history of IE (infective endocarditis, heart failure, heart attack, rheumatic fever, or have previously suffered from heart valve disease. In addition, individuals who participate in intravenous drug use have an increased potential risk of developing heart valve disease.

Patients suffering from coronary heart disease might also have a higher risk of developing heart valve disease. Specific risk factors associated with the development of the disease include high blood pressure, high blood cholesterol, insulin resistance, smoking, obesity or being overweight, diabetes, family history of early-onset heart disease, and a lack of physical activity.

Individuals can be predisposed to heart valve disease at birth if they were born with an aortic valve constructed with two flaps instead of the normal three flaps. In many cases, the individual may have a heart that appears to have only two flaps instead of three because two of the three flaps fused together into a single flat. This is referred to as a bicommissural or bicuspid aortic valve. Being born with this congenital condition tends to increase the likely potential for developing aortic heart valve disease later in life.

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Heart Valve Disease Symptoms

Without an accurate diagnosis, it may not be possible to determine if you have heart valve disease. This is because many individuals never displaying the symptoms yet still experienced significant problems with their heart valve that require treatment. In some cases, the individual suddenly experiences obvious signs of heart valve disease while others’ conditions progress slowly. Even so, there may be significant damage caused by the condition. The most common heart valve disease symptoms include:

  • Chest palpitations or pain involving rapid heart rhythms or skipping beats

  • Swollen abdomen, feet, and ankles

  • Loss of Consciousness

  • Lightheadedness

  • shortness of breath

  • Weakness

  • Fatigue

  • Difficulty in catching a breath

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Diagnosing and Treating Heart Valve Disease

The doctor diagnostician will detect obvious signs of heart valve disease including heart murmurs and other indicators. Typically, the examination is conducted by a cardiologist who specializes in the diagnosis and treatment of heart problems. To accurately diagnose the condition, the doctor will likely conduct a:

  • Physical Examination – The cardiologist will use a stethoscope to listen to the heart to determine if a heart murmur exists which could be an indicator of a heart valve problem. In addition, the doctor will check for fluid buildup by listening to the lungs while the patient breathes. The physical examination will also determine the patient’s body has retained water, which is often an indicator of heart problems.

  • Procedures and Tests – Typically, the cardiologist will recommend an echo (echocardiogram) that can accurately diagnose heart valve disease. In addition, chest x-ray and electrocardiogram can also reveal many the obvious signs of the condition. The patient might need to undergo a cardiac catheterization, cardiac MRI (magnetic resonance imaging) test or stress test.

  • Cardiac MRI – A cardiac magnetic resonance imaging scan of the patient’s chest can provide detailed images of the heart muscle, valves, and other components to its interior structure. Typically, the doctor will recommend this type of test to confirm if a valve defects or damage has occurred. The information the scan, procedures and physical examination can provide the doctor enough information to plan an effective treatment or assist the surgeon when planning a corrective surgical procedure.

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Sources:

https://my.clevelandclinic.org/health/articles/valve-disease-types

https://www.fda.gov/Drugs/DrugSafety/ucm332912.htm

https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforpatientsandProviders/ucm180078.htm

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