Heart Valve Diseases

Introduction The heart has four valves. Normally, these valves open to let blood flow through your heart. The valves then shut to keep it from flowing backward. Sometimes the heart’s valves do not work properly. Valve problems can be present at birth or can happen later in life. Some valve problems do not need treatment. Others might require medicine, medical procedures or surgery to repair or replace the valve. This reference summary explains heart valve diseases. It talks about general symptoms of heart valve diseases. It also talks about common heart valve diseases and their treatments. The Heart The main function of the heart is to pump blood to the lungs and the rest of the body. Two main compartments form the heart. These compartments are called the right heart and the left heart. Each compartment has two chambers: a smaller chamber called an atrium and a bigger chamber called a ventricle. The ventricles are the main pumps of the heart.

Aorta

Left Atrium Right Atrium

Left Ventricle Right Ventricle

Blood comes from the body to the heart through two big veins. This blood enters the right atrium. It is then pumped into the right ventricle through a valve known as the tricuspid valve. The blood is then pumped into the lungs through the pulmonary valve. In the lungs, the blood is loaded with oxygen. It then returns to the left side of the heart, to the left atrium.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 05/22/2014

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Next, the blood is pumped into the left ventricle through the mitral valve. The left ventricle pumps the blood to the rest of the body through the aortic valve. The valves have two functions: • To allow the blood to flow through the heart smoothly. • To prevent the blood from leaking back against the main flow. General Symptoms The main sign of heart valve disease is an unusual heartbeat sound called a heart murmur. Many people have heart murmurs without having any other heart problems. Others may have heart murmurs caused by a heart valve disease, but they have no other signs or symptoms. Heart valve diseases often worsen over time. Signs and symptoms may develop years after a heart murmur is first heard. Other common signs and symptoms of heart valve diseases relate to heart failure, which can be caused by a heart valve disease. These include: • Extreme tiredness. • Shortness of breath, especially when exercising or lying down. • Swelling in the ankles, feet, legs, abdomen and veins in the neck. Heart valve diseases can also cause: • A fluttering, racing or irregular heartbeat. • Chest pain that may happen only when you exert yourself. • Dizziness or fainting. Symptoms do not necessarily determine the seriousness of a person’s valve problems. A valve problem can be severe with no symptoms. A valve problem may also not be very severe but may cause many symptoms.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 05/22/2014

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Types of Heart Valve Diseases There are many different types of heart valve diseases. Heart valve diseases can affect any of the four valves in the heart. Heart valves can have three basic kinds of problems: • Regurgitation. • Stenosis. • Atresia. Regurgitation is when blood leaks back through the valve in the wrong direction. It happens if a valve does not close tightly. Regurgitation is often due to prolapse. Prolapse is when the flaps of the valve flop or bulge back into an upper heart chamber during a heartbeat. Heart Valves Stenosis is when a valve does not open enough. This blocks the flow of blood through the heart. Stenosis happens if the flaps of a valve thicken, stiffen or fuse together. Some valves can have both stenosis and regurgitation problems. Atresia happens if a heart valve does not have an opening for blood to pass through. This prevents blood from being pumped through the heart and to the rest of the body.

Causes Some people are born with heart valve diseases. Others develop them later in life. Heart valve disease that develops before birth is called congenital heart valve disease. Congenital heart valve disease can happen alone. It can also happen with other congenital heart defects. The cause of congenital heart valve diseases is not known. These heart valve diseases happen before birth, as the heart is forming. Heart valve diseases that happen later in life are called acquired heart valve diseases. These heart valve diseases may be caused by: • Heart conditions and other disorders. • Age-related changes in the heart. • Rheumatic fever. • Infections. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 05/22/2014

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Problems that can cause acquired heart valve diseases also include: • High blood pressure. • Heart attacks and heart failure. • Atherosclerosis in the aorta. Atherosclerosis is a condition in which plaque builds up inside the arteries. Plaque is a waxy substance. Age-related changes in the heart can lead to heart valve diseases. Calcium and other types of deposits may develop on heart valves in men older than 65 and women older than 75. Rheumatic fever can develop after an untreated infection with strep bacteria. It can cause heart valve diseases when the body tries to fight the infection. Symptoms of heart valve damage often do not appear until many years later. Germs can sometimes infect the inner surface of the heart, including the heart valves. This rare but serious infection is called infective endocarditis, or IE. IE can develop in people who already have a heart valve disease. It can worsen existing heart valve diseases. Diagnosis Your health care provider will first ask about your symptoms and medical history. He or she will perform a physical exam. Your health care provider may refer you to a cardiologist. A cardiologist is a doctor that specializes in heart conditions. Certain tests may be done to see how the heart is working. Echocardiography, or an echo, is the main test used to diagnose heart valve diseases. An echo uses sound waves to create an image of the heart as it works. The pictures show: • How well the heart is pumping blood. • The size and shape of the heart’s valves and chambers. • Whether a valve is working correctly.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 05/22/2014

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Other tests may also be done. These include: • Electrocardiogram, or EKG. • Cardiac catheterization. • Cardiac MRI. • Chest x-ray. • Stress test. An EKG test detects and records the heart's electrical activity. It can detect an irregular heartbeat and signs of a previous heart attack. It can also show whether the heart chambers are enlarged. Cardiac catheterization uses a thin, flexible tube called a catheter guided to the heart through a blood vessel in the arm, groin or neck. Dye is injected through the catheter. X-rays are then taken to show how the valves are working.

Stress Test

Cardiac MRI uses a powerful magnet and radio waves to make detailed images of the heart. It can confirm information about valve problems. A stress test can show whether you have signs and symptoms of heart valve disease when your heart is working hard. The test is done during exercise. Treatment Treatment for heart valve diseases may include: • Lifestyle changes. • Medicines. • Surgery to repair or replace a faulty heart valve. Lifestyle changes may include quitting smoking and following a healthy diet. A healthy diet includes a variety of vegetables and fruits. It also includes whole grains, fat-free or low-fat dairy products and protein. Certain medicines may be used to treat heart valve diseases. These medicines may: • Lower high blood pressure or high blood cholesterol. • Prevent irregular heartbeats. • Thin the blood and prevent clots. • Widen blood vessels and rid the body of excess fluid. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 05/22/2014

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Surgery may be needed to repair or replace a faulty heart valve. This can prevent lasting damage to your heart. Heart surgeons can repair heart valves by: • Adding tissue to patch holes or tears. This can also increase the support at the base of the valve. • Removing or reshaping tissue. This can make the valve close tighter. • Separating fused valve flaps. Sometimes heart valves cannot be repaired and must be replaced. This surgery involves removing the faulty valve and replacing it with a new valve. There are different types of valves available. If you are getting a valve replacement, talk to your health care provider about your options. Some of these procedures require an operation where the chest is opened to get to the heart. Others are done with catheters inserted through the blood vessels all the way to the heart. Summary The heart has four valves. Normally, these valves open to let blood flow through your heart. The valves then shut to keep it from flowing backward. Sometimes the heart’s valves do not work properly. Heart valves can have three basic kinds of problems: • Regurgitation. • Stenosis. • Atresia. Valve problems can be present at birth or can happen later in life. Your health care provider may refer you to a cardiologist. A cardiologist is a doctor that specializes in heart conditions. Certain tests may be done to see how the heart is working. Echocardiography, or an echo, is the main test used to diagnose heart valve diseases. Some valve problems do not need treatment. Others might require medicine, medical procedures or surgery to repair or replace the valve.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 05/22/2014

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