Valvular heart disease symptoms, causes, diagnosis and treatment guidance.
Overview
What is valvular heart disease (VHD)?
Each heart valve has small flaps that open and close with every heartbeat to keep blood flowing in the correct direction. Valvular heart disease (VHD) happens when one or more of these valves (doors) do not open or close properly, making it harder for the heart to pump blood around the body.
The heart has four valves that help blood flow in the correct direction:
- Aortic valve
- Mitral valve
- Tricuspid valve
- Pulmonary valve
In VHD:
- A valve may become narrow and stiff (stenosis)
- A valve may become leaky and not close properly (regurgitation)
- The valve flaps become stretched out and floppy, leaking blood into the heart (prolapse)
This can make the heart work harder and reduce blood flow to the body.1,2What causes valvular heart disease?
VHD can develop slowly over time or may happen because of another health condition2,3Common causes include:
- Ageing and calcium build-up in the valves
- Rheumatic fever following untreated throat infection
- High blood pressure
- Heart attack or heart disease
- Being born with an abnormal valve (Congenital heart conditions)
- Heart infections such as infective endocarditis
- Previous radiation treatment to the chest
What are the greatest risks of VHD?
If untreated, VHD may lead to:
- Heart failure
- Irregular heartbeat (arrhythmia)
- Stroke
- Blood clots
- Damage to the heart muscle
Signs and symptoms
Common symptoms of VHD include:
- Breathlessness (at rest, during activity or when lying down)
- Chest discomfort or chest pain
- Feeling unusually tired or weak
- Swelling in the ankles, feet or abdomen
- Dizziness or fainting
- Fast or irregular heartbeat (palpitations)
Some people with mild valve disease may not notice symptoms for many years
Tests to diagnose VHD
Tests for heart valve disease may include:
- Echocardiogram (heart ultrasound): Uses sound waves and a small device placed on your chest to create moving pictures of your heart.
- Transoesophageal echocardiogram (TEE): A detailed heart ultrasound using a small tube passed down the food pipe to get clearer pictures of the heart valves.
- Exercise stress echocardiogram: Checks how your heart and valves work while you walk on a treadmill or cycle on an exercise bike.
- Chest X-ray: A quick scan that shows the heart and lungs.
- Cardiac catheterisation (angiogram): Uses dye and X-rays to check blood flow and look at the heart valves and blood vessels.
- Electrocardiogram (ECG/EKG): Small sticky patches placed on the skin record your heart rhythm and electrical activity.
- Magnetic resonance imaging (MRI): Uses magnets and radio waves to create detailed pictures of the heart.
What treatments should I expect?
Treatment depends on:
- Which valve is affected
- How severe the condition is
- Symptoms and overall heart function
Treatment may include lifestyle changes, medicines or procedures.
Lifestyle changes
Healthy lifestyle changes may help reduce symptoms and improve heart health.
These include:
- Stopping smoking
- Staying physically active as advised by your doctor
- Maintaining a healthy weight
- Limiting salt intake
- Managing blood pressure, diabetes and cholesterol
- Eating a heart-healthy diet rich in vegetables, fruits, whole grains, fish, nuts and poultry
- Limiting alcohol intake
- Getting 7 to 9 hours of good-quality sleep each night
Medicines for VHD
Medicines cannot usually cure valve disease, but they may help control symptoms and reduce the risk of complications. Your doctor may also treat related conditions such as high blood pressure, heart failure or irregular heartbeat.
Some medicines may:
- Reduce fluid build-up
- Lower blood pressure
- Help control heart rhythm
- Help prevent blood clots
Procedures and surgery for VHD
If valve disease becomes severe, a procedure or surgery may be needed.
Some options include:
- Balloon valvuloplasty: A balloon is used to widen a narrowed valve
- Valve repair surgery: The damaged valve is repaired
- Valve replacement surgery: The damaged valve is replaced with an artificial or tissue valve
- Transcatheter aortic valve implantation (TAVI): A less invasive procedure used mainly for aortic valve disease
Your doctor will discuss the most suitable option based on your condition and overall health.
Myths and facts
Valve disease is a normal part of ageing.
Although risk increases with age, valve disease requires medical assessment and treatment.
If I do not have symptoms, my valve disease is not serious.
Some people may have severe valve disease without symptoms.
Valve disease can always be treated with medicines alone.
Medicines may control symptoms, but some people eventually need valve repair or replacement.
People with valve disease should avoid exercise completely.
Many people can remain active safely with medical advice and regular follow-up.
Valve surgery is always open-heart surgery.
Some valve procedures such as TAVI can be performed using less invasive techniques.
FAQs
What is valvular heart disease?
Valvular heart disease occurs when one or more heart valves do not open or close properly, affecting blood flow through the heart.
Can valvular heart disease be cured?
Some valve conditions can be repaired or treated successfully with procedures or surgery.
When should I see a doctor?
See a doctor if you have symptoms such as breathlessness, chest pain, dizziness, swelling or palpitations.
Can I live a normal life with valve disease?
Many people with valve disease live active lives with regular monitoring and appropriate treatment.
Will I always need surgery?
Not always. Mild valve disease may only need regular follow-up and medicines. Surgery or procedures are usually considered when symptoms become severe or the heart is affected.
