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Valve Disease

diseased mitral valve. Medical illustration for St. Francis Hospital & Health Centers, Indianapolis

More than 5 million Americans suffer from heart valve disease, which, if untreated, can lead to heart failure and other complications — including death. The onset of heart valve disease often occurs slowly, and people are not aware they have the condition.

What is heart valve disease?
Valve disease occurs when there is a change in the structure of one of the heart valves that results in a valve no longer functioning the way it should. Valves are leaflets in the heart that allow for proper blood flow between heart chambers. Heart valve disease occurs when a valve either fails to open properly (stenosis) or fails to close completely, allowing backward flow of blood (regurgitation).

Stenosis occurs when the valve(s) opening becomes narrowed or valves become damaged or scarred, inhibiting the flow of blood out of the heart’s ventricles or atria (the chambers of the heart). A narrowed or “stenotic” valve requires the heart to pump harder, which can strain the heart and reduce blood flow to the body.

Regurgitation, or a “leaky valve,” occurs when leaflets on the heart valves do not close completely, letting blood move backward through the valve. This backward flow is referred to as “regurgitant flow.”

The sounds created by these abnormalities are commonly referred to as heart murmurs. Valve disease can progress without symptoms and a murmur may be the only indication of a problem. Valve Center physicians evaluate the extent of valve disease and the best form of treatment using a variety of advanced diagnostic tests. Most often, this involves use of sound waves (echocardiography) to image the heart and its valves.

How do the heart valves function?
Every time your heart beats, blood flows into, through and out of your heart. Your heart moves about 100 gallons (379 liters) of blood through your body every hour.

Blood is pumped through your heart in only one direction. The four heart valves play key roles in this one-way blood flow, opening and closing with each heartbeat. Pressure changes behind and in front of the valves allow them to open their flap-like "doors“ (called cusps or leaflets) at just the right time, then close then tightly to prevent a backflow of blood.

The valve is made of strong, thin pieces or flaps of tissue called leaflets. The leaflets are attached to and supported by a ring of tough fibrous tissue called the annulus that helps support and maintain the proper shape of the valve. The valve leaflets can be compared to doors opening and closing. The annulus functions as the doorframe.

What are the different types of heart valves?
Valves are one-way doors that protect the heart chambers from overloading. The heart consists of four chambers, two atria (upper chambers) and two ventricles (lower chambers). There is a valve through which blood passes before leaving each chamber of the heart. The valves prevent the backward flow of blood. These valves are actual flaps that are located on each end of the two ventricles (lower chambers of the heart). They act as one-way inlets of blood on one side of a ventricle and one-way outlets of blood on the other side of a ventricle. Normal valves have three flaps, except the mitral valve, which has two flaps.

How do I know if I have valve disease?
Symptoms of heart valve problems may include:

  • Extreme fatigue: Fatigue is the most common complaint for valve disease.
  • Coughing: Especially at night or when lying down.
  • Trouble breathing after exercise:
  • Shortness of breath, ecspecially when lying down: You may notice this most when you are doing normal daily activities or when you lie flat in bed.
  • Racing or irregular heartbeat: This may feel like a rapid heart rhythm, skipped beats or a “flip-flop” feeling in your chest.
  • Swelling of the ankles, feet or abdomen: This is called edema. Swelling may occur in your stomach, causing you to feel bloated.
  • Dizziness or lightheadedness: You may feel too weak to carry out daily activities. Dizziness can also occur, and in some cases, passing out may be a symptom.
  • Quick weight gain: A weight gain of two or three pounds in one day is possible.
  • Chect discomfort: This may feel like a pressure or weight in the chest with activity or going out in cold air.

If the onset of valve disease is severe and sudden, symptoms can occur quickly. If the disease develops slowly, you may barely notice symptoms. Patients experiencing these symptoms are encouraged to visit the St. Francis Heart Valve Center.

Does age affect your risk for valve disease?
Not necessarily. A family history of valve disease and a previously diagnosed heart murmur are two indicators of a possibility of valve disease. If someone has a family history of valve disease, they will need to be evaluated at an earlier age. If someone is told they have a murmur, then they will need to be investigated with an echocardiogram. If patients have one of these two indicators, they should see their physician as soon as possible.