Heart Valve Disease Symptoms, Diagnosis, and Treatment

Heart Valve Disease: Key Insights and Treatment Options

Heart valve disease is a critical issue affecting millions in India, leading to severe complications and high mortality rates. A recent study on heart valve disease in India was published in the Journal of the American Medical Association in June 2024 (Source). This research focused on rheumatic heart disease (RHD) and analyzed data from 13,696 patients across 24 countries. It revealed a high mortality rate of 4.7% per patient year, primarily due to severe heart valve disease.

But what is heart valve disease, and what are its primary symptoms that can be discovered at an early stage and treated with supportive treatment by a healthcare professional for immediate care? Continue reading to get all the details!

What is Heart Valve Disease?

The heart muscle consists of four chambers: two atria (upper chambers) and two ventricles (lower chambers). Your heart has four valves that play a key role in keeping blood flowing in the right direction through each chamber.

Heart valve disease means one or more valves are not working adequately, i.e., do not open or close properly. This can disrupt the blood flow from the body to the heart and through the heart to the body.

How does Heart Valves Function?

Each valve acts as a one-way door, opening with each heartbeat to let blood flow from its chambers and closing to restrict blood flow backwards. The four heart valves function in the following manner:

• Tricuspid Valve: Controls the blood flow between the right atrium and right ventricle
• Mitral Valve: Controls the blood flow between the left atrium and left ventricle
• Pulmonary Valve: Controls the right ventricle and the pulmonary artery
• Aortic Valve: Controls the left ventricle and aorta

Heart valve disease means any of the four heart valves are not working, disrupting the blood flow.

How is Heart Valve Disease Different From Normal Health Conditions?

Heart valve disease is distinct from normal health conditions due to its impact on the heart's ability to regulate blood flow efficiently. Unlike a healthy heart, which pumps blood seamlessly, heart valve disease involves malfunctioning valves that either do not open fully or close completely. This leads to disrupted blood flow, causing symptoms like fatigue, shortness of breath, and chest pain.

Over time, untreated heart valve disease can result in severe complications such as heart failure, stroke, and sudden cardiac death, contrasting with the well-functioning cardiovascular system of a healthy individual.

Types of Heart Valve Disease

There are a few types of heart valve disease, and some people may have a combination of more than one type:

1. Valvular Stenosis (Narrowing): The stiffness in the heart valves can narrow the valve opening (flaps) size and restrict the blood flow. The valve opening can narrow in severe cases, making the body struggle to get enough blood flow.
2. Valvular Prolapse (Slipping Out of Place): When the valve flaps slip out of place or form a bulge, the heart valve closes unevenly. During this condition, the blood may leak backwards through the valve.
3. Valvular Regurgitation (Leaking): The valve flaps may not close tightly, causing blood to flow backwards.
4. Valvular Atresia: The valve isn't formed correctly, and the tissues block the blood flow between the heart chambers.

Heart Valve Disease Causes

Heart valve disease or valvular heart disease may develop before or at the time of birth or anytime after birth. Some of the possible causes of heart valve disease may include:

Congenital Causes (Developed at Birth):

• Defect in the heart valve (wrong size or wrong space)
• Valve flaps not working properly
• Bicuspid aortic valve disease (presence of two leaflets instead of three)
• Marfan syndrome (a genetic disorder affecting the body's connective tissues)

Acquired Causes (Developed after Birth):

• Rheumatic fever (may affect the heart valve if not treated properly)
• Infective endocarditis (common germs travelling through the bloodstream to the heart and infecting the surface of the heart)
• Undergone radiation therapy
• Degenerative changes with age

Other Causes:

• Coronary artery disease
• Damage to a heart muscle due to a heart attack
• Metabolic disorders
• Tumor in heart
• Certain medications

What Are Heart Valve Disease Symptoms?

In some individuals, heart valve disease may show no symptoms, while others may experience one or more symptoms, which may be mild, moderate, or severe. The common symptoms of heart valvular disease may include:

• Feeling breathlessness
• Chest discomfort
• Irregular or rapid heartbeats leading to arrhythmia
• Feeling weak or dizzy
• Fatigue or weakness in doing routine activities
• Swollen ankles and feet
• Lightheadedness or dizziness
• Tiredness than usual
• Fluttering or pounding feeling in your chest (called palpitations)

Except for the above-mentioned symptoms, one of the first signs of heart valve disease is often a heart murmur that the doctor may encounter while listening to your heartbeat with a stethoscope. Later on, they perform diagnostic tests to examine the condition.

Heart Valve Disease Symptoms in Newborns and Young Children

• Not gaining weight
• Slow growth
• Blue skin tone, especially in lips, toes, and fingers
• Low oxygen levels in the blood
• Rapid pulse or breathing
• Cool or clammy hands
• Weak pulse

Levels of Heart Valve Disease

Based on the severity, your healthcare professional may describe the heart valve disease into three levels: mild, moderate, and severe. For each level, different treatment methods are followed. Let's understand the levels in detail:

Mild Heart Valve Disease

• No such symptoms are observed, and you may require no treatment
• Suggested health check-ups, including echocardiogram every 3-5 years
• Medicines can help make the heart work better and improve symptoms.

Moderate or Severe Heart Valve Disease

• If diagnosed with moderate heart valve disease with no symptoms, you need a check-up and echocardiogram every 6-12 months.
• Treatment will be needed to prevent the worsening symptoms from getting worse.

Severe Heart Valve Disease

• It may get worse if the moderate stage is not treated at the right time.

Potential Complications Heart Valve Disease Can Cause

Based on the severity, the heart valve disease can cause certain complications, including:

• Heart failure
• Blood clots
• Heart rhythm abnormalities
• Death
• Stroke

How is Heart Valve Disease Diagnosed?

The diagnosis tests for heart valve disease may vary depending on the multiple symptoms an individual is experiencing and the physical exams conducted. The tests for heart valve disease may include:

Suggestion: If you have been diagnosed with heart valve disease, consult with a cardiology specialist as soon as possible.

What are Heart Valve Disease Treatment?

At the minor stage, you may require less to no treatments, but regular tests are required to keep an eye on if it worsens. In case of severity increases, more aggressive treatments are needed.

What are Heart Valve Disease Treatment?

At the minor stage, you may require less to no treatments, but regular tests are required to keep an eye on if it worsens. In case of severity observed, you may need intensive treatment or surgery sometimes. The treatment depends on the cause of the heart valve disease and its impact on your heart. The following treatments may help to cure heart valve disease based on the severity observed:

Medication:

Medicines cannot cure heart valve disease but may help relieve swelling, abnormal heartbeat, high blood pressure, etc. It may be suggested that you take medicines when your heart valve disease is mild or moderate or does not require surgery. The medications reduce the workload or stress on your heart. Some medicines that may be prescribed are:

Surgery:

Different heart valve surgeries may be performed based on the causes of the valve issues and the effects of the damage on your heart or lifestyle:

How to Prevent Heart Valve Disease?

You can take preventive measures and support overall heart well-being by making healthy lifestyle changes, which include:

• Regular exercise
• Maintain a healthy weight
• Eat a healthy and balanced diet
• Stop smoking
• Reduce the alcohol intake
• Stress management