Definition

Heart valve disorders can be congenital or result from infections, heart attacks, or structural damage to the heart. The primary symptom of heart valve disorders is an abnormal heart sound (heart murmur), which can be detected with a stethoscope. Some heart valve issues do not require immediate treatment and are not emergencies, but in certain cases, medical procedures or heart valve replacement surgery may be necessary.

Your heart has four valves that function as gates controlling the direction of blood flow. These valves open to allow blood to pass through and close to prevent backflow. However, sometimes the heart valves fail to function properly.

In general, there are three main conditions associated with heart valve disorders:

• Valve regurgitation: This occurs when blood flows backward through the valve.
• Valve stenosis: This is when a valve does not open fully, restricting blood flow.
• Absent valve: In this case, the valve does not form and is replaced by tissue that blocks blood flow between heart chambers.

Causes

The heart has four chambers (two atria and two ventricles), each with a valve ensuring blood flows in the right direction and preventing backflow. These valves are made up of thin structures that open and close with each heartbeat.

Valve abnormalities can result from various causes, including bacterial infections. A bacterial infection can damage the valve structure, preventing it from opening or closing properly, which disrupts blood flow and creates a characteristic murmur as a sign of valve dysfunction.

Other causes of heart valve disorders include:

• Congenital heart disease, where the child is born with abnormal valves
• Rheumatic fever
• Cardiomyopathy
• Heart muscle damage due to a heart attack

Risk Factor

Some risk factors for heart valve disorders include:

1. Age

As people age, the heart structure weakens, affecting valve function, especially in the elderly.

2. History of Heart Infection

Those with a history of heart infections or heart attacks are at risk of valve disorders.

3. High Blood Pressure and Cholesterol

High blood pressure, elevated cholesterol levels, and other factors that contribute to heart disease increase the risk of valve disorders.

4. Congenital Heart Disease

Heart valve disorders present from birth (congenital) are often due to developmental issues in the womb that result in incomplete valve formation.

Symptoms

Some individuals with heart valve disorders may appear normal and show no symptoms for years. However, common symptoms include abnormal heart sounds heard with a stethoscope, chest pain, swelling in certain areas of the body, fatigue, shortness of breath (especially during activity or when lying down), dizziness, irregular heartbeat, and loss of consciousness.

Diagnosis

Your doctor will assess you by listening for abnormal heart sounds, a key symptom of heart valve disorders. An echocardiogram may be performed, which uses sound waves directed at your heart to produce images on a monitor. This test helps examine the heart’s structure, valves, and blood flow. It can reveal valve function and identify any issues with opening or closing that might cause turbulent blood flow and abnormal heart sounds.

Other diagnostic tests include:

• EKG (Electrocardiogram): This measures the heart's electrical activity using electrodes placed on the skin. It can detect irregular heart rhythms and heart chamber enlargement.
• Chest X-ray: This helps doctors identify enlarged heart chambers.
• Cardiac MRI: This provides detailed images of the heart's size and function.

Management

Treatment depends on the severity of your condition and symptoms. A cardiologist will monitor your condition over time and recommend lifestyle changes to improve heart health. Medications may also be prescribed to relieve symptoms.

For more severe cases, surgery may be required to repair or replace the damaged valve. In some cases, the surgeon may only need to repair the valve by tightening or supporting it to ensure normal function. If a replacement is needed, the damaged valve can be replaced with either a mechanical valve or one made from animal or human tissue.

If a mechanical valve is used, you will need to take blood-thinning medications for life to prevent blood clots. However, valves made from biological tissue tend to deteriorate over time and may eventually need replacement.

Complications

Complications from heart valve disorders include heart failure, stroke, blood clots, arrhythmias, and even death. Damaged heart valves can alter blood flow, causing turbulence that impacts heart chamber walls. This can lead to heart failure. High cholesterol levels can increase the risk of stroke if a blood clot blocks blood flow or if a blood vessel bursts. Valve damage can also cause blood clotting, heightening the risk of stroke.

Prevention

If you have a known heart valve disorder, it’s essential to take precautions to prevent complications, even after surgery to repair or replace the valve. Important preventive measures include:

• Knowing the type and severity of your valve disorder
• Regular check-ups
• Following a healthy lifestyle as advised by your doctor
• Discussing safe physical activities and maintaining a balanced diet
• Maintaining a stable weight
• Managing stress
• Avoiding smoking and excessive alcohol consumption, as smoking can damage blood vessels

For women with valve disorders, consult your doctor before becoming pregnant. Your doctor will guide you on safe medications during pregnancy and assess the risks based on the severity of your condition. In severe cases, postponing pregnancy may be recommended to avoid complications.

When to See a Doctor?

If you experience symptoms such as fatigue, shortness of breath, palpitations, cold sweats, dizziness, or chest pain, see a doctor immediately. If abnormal heart sounds are detected, your doctor will refer you to a cardiologist for further evaluation.

If you have a history of heart disease, regular check-ups are recommended. Inform your doctor of any medication allergies to ensure the best treatment.

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