Smart-Take: Heart Valve Disease

The heart has four valves—tricuspid, pulmonary, mitral, and aortic—which have flaps that open and close with each heartbeat and make sure blood is flowing in the right direction. Unfortunately, it doesn’t always work that way. Five million people are diagnosed each year with some kind of heart valve disease, primarily through the use of an echocardiogram. Valve damage takes three primary forms:

  • Regurgitation is leakage or backflow into the chambers caused when the valve does not shut tightly. It most commonly occurs due to valve prolapse with the mitral valve most often impacted.
  • Stenosis occurs when the valves can’t open all the way, typically because they have thickened, stiffened, or fused, so the blood does not adequately flow through the valve.
  • Atresia results when there is no opening for the blood to flow through.

According to the American Heart Association, many patients with mitral valve prolapse don’t experience symptoms, and the problem is discovered with a “murmur” that may be detected during a routine physical. A risk assessment is then performed before a course of action is chosen—often a watch-and-wait scenario until symptoms or heart function gets worse, or the left ventricle of the heart is enlarged. Stenosis, which may impact any of the four valves, becomes increasingly more common with age, but it can also be caused by congenital defects. In addition, some valve conditions develop due to illnesses, such as rheumatic fever and infective endocarditis.

A range of medications (see right) may be prescribed to lessen the symptoms of valve damage. Many valve disorders are also surgically treatable with repair or replacement.

STAY AWARE

Many people with heart valve disorders may not exhibit any symptoms—or may not notice slowly-developing ones. The damage that valve disorders may cause can be significant, however, so it’s important to recognize symptoms when they arise.

MEDICATIONS FOR A VALVE DISEASE PATIENT

  •  ACE Inhibitors: Opens blood vessels more fully, can help reduce high blood pressure, and slows heart failure.
  • Antiarrhythmic Medications: Helps restore a normal pumping rhythm to the heart.
  • Antibiotics: Helps to prevent the onset of infections.
  • Anticoagulants ("Blood Thinners"): Reduces the risk of developing blood clots from poorly-circulating blood around faulty heart valves. Blood clots are dangerous because they can lead to stroke.
  • Beta Blockers: Reduces the heart's workload by helping the heart beat slower. Some patients find them helpful for reducing palpitations.
  • Diuretics ("Water Pills"): Reduces the amount of fluid in the tissues and bloodstream, which can lessen the workload on the heart.
  • Vasodilators: Lowers the heart's work by opening and relaxing the blood vessels; reduced pressure may encourage blood to flow in a forward direction, rather than being forced backward through a leaky valve.

SOURCE: American Heart Association

www.heart.org