Understanding Heart Valve Disease: Types, Causes and More

Any condition affecting the functioning of one or more of the four cardiac valves, namely, mitral, aortic, tricuspid, and pulmonary, is deemed as a heart valve disease.

The heart valves play a critical role in correct blood flow from the heart to the rest of the body. These valves expand and contract with every heartbeat to maintain blood circulation and prevent backflow.

When a valve malfunctions and doesn’t open fully, it is called stenosis, and when it doesn’t close properly, it is called regurgitation. These two conditions are the most common heart valve diseases. They disrupt efficient blood flow and can result in fatigue, chest pain, and shortness of breath.

Types of Heart Valve Disease

Heart valve disease is broadly classified into three main types: valvular stenosis, valvular regurgitation, and combined valvular lesions.

These conditions mainly affect the heart’s functionality, reducing its efficiency to pump and circulate blood. To diagnose and treat them correctly, it is important to have a detailed understanding of these conditions.

1. Valvular stenosis

This condition occurs when the valve opening of the heart becomes more narrowed or stiffer than usual. This can restrict blood flow through the valve, putting added stress on the heart to pass blood via the smaller opening.

Without proper diagnosis, this added strain can cause complications like arrhythmia (irregular heartbeats) and make one more prone to heart failure. Some common causes of this condition are:

• Congenital valve abnormalities

• Calcification due to ageing

• Underlying conditions such as rheumatic fever

2. Valvular regurgitation

When the heart valve does not close properly, it results in a condition called valvular regurgitation. Also called valvular insufficiency, this condition results in pumped blood leaking backwards into the heart chamber. This reduces the heart’s efficiency in pumping over time and puts more strain on it. When the heart works harder to compensate, it can lead to symptoms like fatigue, breathlessness, and swelling.

Some common causes of this condition include:

• Valve prolapse

• Infections like endocarditis

• Heart damage from a cardiac arrest

3. Combined valvular lesions

When stenosis and regurgitation happen at the same time, it can lead to valvular lesions. This condition can affect either the same valve or different valves simultaneously. A combination of this disease is deemed more severe and can lead to worse complications since the heart struggles with both restricted blood flow and backward leakage. 

Causes and Risk Factors

Heart valve disease stems from multiple causes and risk factors, and it is crucial to understand them for early diagnosis and cure.

1. Congenital heart defects

Congenital heart defects are birth abnormalities affecting the heart valves. Some individuals may be born with two aortic valves (bicuspid) instead of the normal tricuspid structure. These congenital defects can majorly affect valve function over time and lead to stenosis or regurgitation with age.

2. Rheumatic fever

Rheumatic fever is another common cause, especially in individuals who have limited healthcare. It is a heart problem caused by inflammation and can develop due to strep throat or scarlet fever. When these conditions are untreated or not properly treated, they can cause heart scarring or irreparable damage to the valves. This can lead to stenosis or regurgitation years after the initial infection. 

3. Age-related changes

Heart valve disease is quite common in older adults and is a part of the natural ageing process. It can be caused due to excessive calcium deposits on the valves over time. This can make the aortic valve stiffen and become narrow, leading to calcific aortic stenosis. Often, ageing also weakens valve tissues, making them more prone to regurgitation. 

Symptoms and Diagnosis

Heart valve disease has different symptoms ranging from mild to severe, depending on how serious the valve dysfunction is. Hence, it is important to understand the symptoms to initiate treatment as early as possible.

1. Common symptoms

Some of the common symptoms of this disease are:

• Shortness of breath during physical activity or when lying down

• Fatigue

• Chest pain

• Swelling (oedema), commonly seen in the ankles, feet, or abdomen

• Dizziness or fainting

• Loss of consciousness

• Heart arrhythmia

• Abdominal pain

2. Diagnostic tests

Patients exhibiting such symptoms require immediate medical assistance, under which various diagnostic tests can be run to detect a potential heart valve disease. Some of them are:

• Echocardiogram

• Electrocardiogram (ECG)

• Chest X-ray

• Cardiac MRI

• Cardiac catheterisation

• Transesophageal echocardiogram (TEE)

Impact on Cardiovascular Function

Both types of heart valve disease disturb the smooth, one-way flow of blood through the heart and body. Here’s how each heart valve disease affects blood flow:

• Narrowed valve openings caused by stenosis restrict blood flow, reducing the amount of blood reaching vital organs.

• Leaky valves caused by regurgitation allow blood to flow backwards, leading to inefficient circulation.

Without proper diagnosis and treatment, heart valve disease can wreak havoc on one’s body and overall quality of life. Some of its effects include:

• Heart failure

• Blood clots

• Heart rhythm abnormalities

• Stroke

• Death

Treatment and Management Options

Timely diagnoses of heart valve disease are treated with a significant number of management strategies, starting with medications.

These are medications usually prescribed to manage heart valve disease: 

• Diuretics

• Beta-blockers

• ACE inhibitors or ARBs

• Anticoagulants

• Antiarrhythmics

In worse cases of the heart valve diseases, the heart health is usually restored via the following surgical interventions depending on the condition and the cause:

• Valve Repair: Fixing the damaged valve to restore proper function is often preferred when possible.

• Valve Replacement: Replacing the valve with a mechanical or biological prosthesis for severe cases.

• Transcatheter Aortic Valve Replacement (TAVR): A minimally invasive procedure for replacing aortic valves in patients unsuitable for open-heart surgery.

• Balloon Valvuloplasty: A less invasive option to widen narrowed valves, often used temporarily or for specific cases like children or young adults.

Lifestyle Considerations for Heart Valve Disease

One suffering from heart valve disease needs to make certain changes in their lifestyle to curb the consequences of this disease and walk the path of a healthy life. Some of the lifestyle modifications which make this feat achievable include:

• A low-sodium diet

• Eating Heart-healthy fats

• Having High-fiber foods

• Moderate alcohol intake

• Proper Hydration

In addition, physical activity can also improve heart health. For best results, try regular moderate exercise such as brisk walking, cycling or swimming. However, avoid high-intensity workouts like running or cardio exercises. Also, stop exercising immediately if you experience chest pain, dizziness, or unusual fatigue.

Living with Heart Valve Disease

Millions of people suffer from heart valve disease; however, with effective management strategies, leading a healthy and fit life is very much possible. Here’s what one should follow.

• Scheduling routine check-ups

• Undergoing echocardiograms 

• Reporting any new or worsening symptoms

• Taking prescribed medications 

• Following lifestyle adjustments

In addition to these practices, psychosocial support is also required to navigate these tough times. With proper care and a strong support system, individuals with heart valve disease can lead a fulfilling life.

Preventive Measures

The best defence is a good offence; hence, inculcating preventive measures to reduce the chances of getting heart valve disease is ideal.

Here are some ways you can potentially reduce the risk of heart valve disease and work towards actively maintaining a heart-healthy lifestyle:

• Eat a balanced diet

• Stay physically active

• Avoiding smoking

• Monitor existing conditions (high blood pressure, diabetes, and cholesterol)
  Routine check-ups can help detect heart valve issues early. Therefore, make sure you undergo periodic heart health checkups that will allow for timely intervention to prevent complications and maintain heart health.

Conclusion

Heart valve disease can put a lot of strain on the heart if ignored. Early diagnosis, treatment, and lifestyle changes can help manage the condition and maintain a good quality of life. Moreover, medical research is constantly advancing. Many promising solutions, new and effective procedures and therapies are available now. This has revolutionised heart disease treatment, making it more effective and less invasive.

The future holds hope for even better ways to detect and manage heart valve disease, making it easier for people to live healthier lives with the condition.