What is heart valve disease?
Heart valve disease is when 1 or more heart valves don’t work right. The valves normally keep blood flow moving forward in one direction. And they prevent the backward flow of blood as it leaves each chamber of the heart. The heart has 4 chambers:
2 upper chambers (atria) and 2 lower chambers (ventricles). The heart also has 4 valves. They are:
- Tricuspid valve. Located between the right atrium and the right ventricle.
- Pulmonary valve. Located between the right ventricle and the pulmonary artery.
- Mitral valve. Located between the left atrium and the left ventricle.
- Aortic valve. Located between the left ventricle and the aorta.
As the heart muscle contracts and relaxes, the valves open and close, letting blood flow into the ventricles and out to the body at alternate times. The following is a step-by-step explanation of blood flow through the heart:
- The left and right atrium contract once they are filled with blood. This pushes open the mitral and tricuspid valves. Blood is then pumped into the ventricles.
- The left and right ventricles contract. This closes the mitral and tricuspid valves, preventing backward blood flow. At the same time, the aortic and pulmonic valves open to let blood be pumped out of the heart.
- The left and right ventricles relax. The aortic and pulmonic valves close, preventing backward blood flow into the heart. The mitral and tricuspid valves then open to allow forward blood flow within the heart to fill the ventricles again.
Heart valves can develop both regurgitation and stenosis at the same time. Also, more than 1 heart valve can be affected at the same time. Some of the more common heart valve diseases are:
- Bicuspid aortic valve. With this birth defect, the aortic valve has only 2 leaflets instead of 3. It is more likely to narrow over time. If the valve becomes narrowed, it is harder for the blood to flow through. Often the aortic
valve may also develop regurgitation in addition to stenosis. Symptoms often don’t appear until the adult years.
- Mitral valve prolapse. With this defect, the mitral valve leaflets bulge and don’t close correctly during the contraction of the heart. This may lead to a lot of regurgitation over time.
- Mitral valve stenosis. With this problem, the mitral valve opening is narrowed. It is often caused by a past history of rheumatic fever. It increases resistance to blood flow from the left atrium to the left ventricle.
- Aortic valve stenosis. This valve disease occurs mainly in older adults. It causes the aortic valve opening to narrow. This increases resistance to blood flow from the left ventricle to the aorta.
- Pulmonary stenosis. With this valve disease, the pulmonary valve does not open enough. This forces the right ventricle to pump harder and enlarge. This is often a condition that is present at birth (congenital).
What causes heart valve disease?
The causes of heart valve disease include:
- Changes in the heart valve structure because of aging
- Coronary heart disease and heart attack
- Heart valve infection (endocarditis)
- Birth defect
- A sexually transmitted infection (syphilis)
- An inherited connective tissue disorder that weakens the heart valve tissue (myxomatous degeneration)
- Radiation such as radiation therapy aimed at the chest wall to treat lymphoma
- Medicines such as the now-banned diet pill Phen-Fen
What are the symptoms of heart valve disease?
You may not have any symptoms if you have mild to moderate heart valve disease. The most common symptoms are:
- Chest pain
- Fluttering heartbeat (palpitations)
- Severe tiredness (fatigue)
- Dizziness or fainting
- Low or high blood pressure, depending on the type of valve disease
- Shortness of breath with activity or rest
- Belly pain because of an enlarged liver (if the tricuspid valve isn’t working correctly)
- Leg swelling