What is Valvular Heart Disease ?

Valvular heart disease or simply heart valve disease takes place when the valves of the heart do not work in the way they are supposed to. In the United States on an annual basis, five million people are diagnosed with valvular heart disease according to the American Heart Association. Let’s take a closer look at this debilitating medical condition.

Valvular heart disease or heart valve disease may be present at birth (congenital) or it may develop at any time during a person’s life. There are occasions when the exact cause of valvular disease is not known.

Valvular heart disease is made up of:

 - congenital valve disease

 - bicuspid aortic valve disease,

 - acquired valve disease

 - mitral valve prolapse (MVP).

When valve disease is present at birth it is referred to as congenital valve disease. This type generally affects the pulmonic valve or the aortic valve. Sometimes the valves are simply the incorrect size or the leaflets have not formed properly.

Bicuspid aortic valve disease is congenital as well and in this case the bicuspid aortic valve has two cusps or leaflets instead of the three it is supposed to have. This can cause the valve to be stiff, leaky or both.

Acquired valve disease is any problem that occurs to a healthy valve. Healthy valves can be affected by disease or infection. Rheumatic fever is just one example. This causes the heart valve to become red and inflamed and the leaflets to cling together. This will lead to the heart valves becoming thickened, rigid, shortened and scarred. This may then lead to mitral regurgitation. Rheumatic fever is most often brought on as a result of a bacterial infection, one of the most common being strep throat. The incidence of this infection has been minimized by the availability of antibiotics.

Endocarditis is another disease that can cause acquired valve disease. This disease happens when bacteria and germs make their way into the bloodstream and invade the heart valves. The result is the appearance of growths and holes within the heart valves. This may then lead to scarring of the heart valves. The end result is leaky heart valves. Germs that cause endocarditis can occur as the result of surgery, IV drug use, dental surgery and/or other serious types of infections. Anyone who suffers from valve disease (excluding those who have mitral valve prolapse) has a greater chance of getting endocarditis, which can be fatal if not treated immediately.

Mitral valve prolapse (MVP) is very widespread and every year affects on average one to two percent of the American population. This disorder causes the mitral valve leaflets to fall back into the left atrium while the heart is contracting. MVP also changes the shape of the valve tissues, they become stretchy and cause seepage. It is rare to see symptoms with MVP and most of the time it does not necessitate any kind of special medical treatment.

The above diseases and disorders are the most common causes of MVP but there are other causes as well. If you happen to be diagnosed with MVP then a visit to the doctor followed by a variety of tests should help pinpoint the exact cause.

Other known causes include:

- coronary artery disease,

- cardiomyopathy (or heart muscle disease),

- heart attack,

- hypertension,

- aortic aneurysms,

- connective tissue diseases, and

- sexually transmitted disease (the most common being syphilis)

There are also less common reasons for valve disease such as tumors, radiation and an assortment of drug treatments.

How your heart works

The heart consists of four chambers and at the exit of each chamber there is a valve. Each valve permits the flow of blood in a one-way system through to the heart. It is the job of each of the four heart valves to ensure that blood flows easily and freely in a simple and forward direction to the heart. They also ensure that there is no leakage of blood in a backward direction. It is important to note that blood flows from “your right and left atria into your ventricles through the open mitral and tricuspid valves.”

When the ventricles are full of blood both the tricuspid as well as the mitral valves completely shut in order to prevent any blood from managing to flow backwards into the atria. In the meantime the ventricles go through a squeezing or contracting motion.

When the ventricles start there contracting motion, this forces the aortic and pulmonic valves to open and blood is then pumped from the ventricles through the open valves. The blood then continues into the pulmonary artery and from there is taken in the direction of the lungs, the aorta of the heart and finally the rest of your body. Once the ventricles stop contracting they are then able to relax. When this relaxation occurs, it causes both the aortic and pulmonic valves to close. By doing so, the valves do not allow any blood to make its way back into the ventricles. This pattern of blood transportation is done over and over again and makes it possible for blood to maintain a consistent flow to the heart, the lungs and to every area of your body.

There are different kinds of valvular heart disease

Generally it is classified as being valvular stenosis and valvular insufficiency.

Valvular stenosis takes place when the opening for a valve is smaller than it should be due to leaflets that are fused or stiff. The narrow opening means that the heart has to work harder to pump the correct amount of blood through it. Valvular stenosis can lead to heart failure if not kept in check. When four valves of the heart are deemed as “stenotic” this means that they are hardened and blood flow is restricted. In this way the name of the condition becomes known as:

 pulmonic stenosis

 aortic stenosis

 mitral stenosis

 tricuspid stenosis                                                                                                                   

Valvular insufficiency is when a valve is not able to close as tightly as it should do. This condition causes blood to leak backwards and causes the heart to work harder and insufficient blood reaches the body. Valvular insufficiency is sometimes called a “leaky valve”, or incompetence or regurgitation.

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