Valvular Diseases - Symptoms, Risk factors and Treatment

Valvular heart disease is a condition when any of the four valves or more than that of your heart are damaged. Your heart has four valves that play an essential role in preventing the backflow of blood, thereby enabling efficient filling of the chambers. 


Understanding the normal functioning and structure of the heart


Your heart is surrounded by a layer called pericardium- a two-layered fluid-filled sac that supports and protects your heart. The pericardium protects your heart from infections and malignancies. Moreover, it prevents your heart from expanding, which occurs when blood volume is increased. Therefore, keeping it functioning properly. On the inside, the heart has four chambers, the upper two atria. And the lower two ventricles, and two sides- the left side and the right side. The right side of the heart pumps blood to your lungs to receive oxygen, while the left side of your heart receives that blood from the lungs and pumps it to the whole body. The left side of the heart has oxygenated blood and the right side of the heart has deoxygenated blood. Your lungs receive oxygen-poor blood from the right side of the heart via the pulmonary artery. In the lungs, the blood receives oxygen and becomes oxygen-rich, and is then carried to the left side of your heart via the pulmonary vein. 


In between the chambers, your heart has valves that ensure efficient blood flow. 


The tricuspid valve is located between the right atrium and the right ventricle. It ensures adequate blood flow from the right atrium to the right ventricle. 


The pulmonary valve is located between the right ventricle and the pulmonary artery. It ensures efficient blood flow from the right ventricle to the pulmonary artery.


The mitral valve, also known as the tricuspid valve, is located between the left atrium and the left ventricle. It ensures efficient blood flow from the left atrium to the left ventricle. 


The aortic valve is located between the left ventricle and the aorta. It ensures efficient blood flow from the left ventricle to the aorta.



Causes 


There are two main causes of heart valve disease, regurgitation or stenosis of valves. 


Heart valve regurgitation

 

Under normal conditions, the heart valves ensure that the blood flows efficiently from one chamber to another without any backflow. In regurgitation, it does not close completely. Due to this, the blood pools backward. The volume of blood that flows forward gets low. It can lead to volume overload of the heart. Moreover, the blood that pools backward can become a hub of infections. Therefore, people having mitral valve regurgitation are asked to take prophylaxis antibiotics. 


Heart valve stenosis 


Under normal conditions the heart valves are flexible. They adjust themselves according to the blood flow. In heart valve stenosis, the valves become narrowed. Due to which the heart has to work harder to push blood forward. 



More than one heart valve can be diseased at a time. Also, the same valve can develop both, stenosis and regurgitation at the same time. When valves become faulty, it can have severe adverse effects on the heart. Problems of the heart valve are a common cause of heart failure. 



Symptoms 


The symptoms of heart valve diseases are; 


  • Breathless on exertion

  • Fatigue

  • Weakness

  • Coughing

  • Breathless on lying down

  • Weight gain

  • Swollen ankles, feet, or legs

  • Loss of appetite

  • Frequent urination at night


Diagnosis 


After taking a history and doing a physical examination, your doctor might order these tests to reach a diagnosis of heart valve disease. 


ECG (Electrocardiogram) -This is done to check the rhythm of your heart.

Chest X-Ray: This is done to check for any problem in your heart or lungs.

Echocardiogram: This test uses sound waves to take images of your heart that reveal information about any problem in the chambers, valves, or any other part of your heart. Your doctor will see ejection fraction to diagnose heart failure. Ejection Fraction is the amount of blood that your left ventricle pumps out during each contraction.


Blood tests: Your doctor may order blood tests like urea, creatinine, BNP (Brain Natriuretic Peptide), etc. to help diagnose heart failure.


Conclusion 


Valvular heart disease is a condition when any of the four valves or more than that of your heart are damaged. It can not be treated with medications. But the symptoms can be managed with medications. However, sometimes no intervention is needed. If needed, the valves can be repaired through surgery or a prosthetic valve can be placed. 


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