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Valvular Heart Disease Overview

Valvular heart disease occurs when your heart valves do not work correctly, characterized by either damage or a defect in one of the four heart valves.


The mitral and tricuspid valves control the flow of blood between the upper chambers (atria) and the lower chambers (ventricles). The pulmonary valve controls the flow of blood from the right side of heart to the lungs, and the aortic valve regulates blood flow between the heart and the aorta. The mitral and aortic valves are most frequently affected by valvular heart disease.


Valves function normally when blood flows with proper force and direction through the heart. Valvular heart disease occurs when valves become too narrow or hard to open fully and blood flow is reduced (stenosis) or when valves are unable to close completely, thus allowing the blood to leak backward across the valve (incompetency, insufficiency or regurgitation). In general, valvular heart disease causes the heart to work harder to circulate the right amount of blood throughout the body.


Valvular heart disease has a variety of causes, some present at birth (congenital) and others acquired later in life. High blood pressure, atherosclerosis, heart attacks, cardiomyopathy and aging may severely affect the valves as well as some migraine and previously marketed diet medications. Some infections and disorders that may lead to valvular heart disease include:


  • Rheumatic fever, which can cause a common type of heart valve disease, rheumatic heart fever. This most often affects the mitral valve, causing it to become narrowed or leaky.
  • Endocarditis, a potential life-threatening infection in which bacteria attaches to the heart valves causing growths or scars. These germs most often enter the body through improper sterilization during surgery or through poor dental hygiene.
  • Carcinoid tumors, rheumatoid arthritis, lupus or syphilis

Other causes include myxomatous degeneration, which is a weakening of valve tissue caused by energy changes in the body; calcific degeneration, which involves valves thickening due to a buildup of calcium on the aortic or mitral valves; and congenital defects involving an irregularly shaped aortic valve or narrowed mitral valve.


Symptoms

Many patients do not exhibit symptoms in the early stages of valvular heart disease, but signs can occur suddenly and increase in severity as the disease develops. Many of the symptoms are similar to those related to congestive heart failure, such as shortness of breath even with limited activity and swelling of the feet, ankles, hands or abdomen. A murmur detected by your physician may be a marker of valvular disease. Other symptoms include:


  • Rapid or irregular heartbeat or pulse
  • Dizziness or fainting (with aortic stenosis)
  • Fever (with endocarditis)
  • Rapid weight gain

Risk Factors

Older people are most at risk of developing valvular heart disease, based on estimates that 1 of 8 people aged 75 or older will suffer at least a moderate form of the condition. Also, people who have a history of endocarditis, rheumatic fever, heart attack or heart failure are more at risk.


Other major risk factors include:


  • High blood pressure
  • High cholesterol
  • Smoking
  • Diabetes
  • Obesity
  • Lack of physical exercise
  • Family history of heart disease