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Common Heart Valve Disorders

by | Apr 1, 2024 | Info | 0 comments

Heart Valves Problems Overview

Heart valves help ensure that blood flows steadily in the right direction without backward leakage. If a person has a heart valve disorder, their valves do not work as they should. This may be due to a narrowing of the valves, blood leakage, or a combination of the two.

The heart has four valves, which have flaps that open and close with every heartbeat. This allows blood to flow through the chambers of the heart and the rest of the body.

Function of the Heart Valves

The heart has four valves, each of which connects to a chamber of the heart. These chambers are known as the right and left atriums, which sit at the top of the heart, and the right and left ventricles, which sit at the bottom.

The valves and their functions are below:

  • Tricuspid: When blood has been around the body and needs more oxygen, it comes back to the heart’s right atrium. The tricuspid valve sits between the right atrium and right ventricle, allowing the blood to flow from the top to the bottom.
  • Pulmonic: This valve carries blood from the right ventricle to the pulmonary artery, which takes blood to the lungs. The blood receives more oxygen when it reaches the lungs.
  • Mitral: After blood becomes oxygenated, it comes back to the left atrium of the heart. The mitral valve regulates blood flow from the left atrium down to the left ventricle.
  • Aortic: This valve connects the left ventricle to the aorta, allowing blood to leave the heart and circulate around the body.

All heart valves have three flaps, or leaflets, to control the flow of blood. The only exception is the mitral valve, which has two leaflets.

Types of Heart Valve Disorder

There are several broad types of heart valve disorder, including the following:

  • Atresia, when the heart is missing a valve, so blood cannot flow properly from one chamber to another
  • Prolapse, which occurs when the valve leaflets do not close as they should 
  • Regurgitation, when blood leaks back through the valve in the wrong direction
  • Stenosis, which occurs when a valve becomes hard and narrow, restricting the flow of blood across it

Common Heart Valve Disorders

Heart valve disorders get their name from the valve they affect and the specific problem affecting it. Some common heart valve disorders include the below.

Mitral stenosis

Mitral stenosis is a form of valvular heart disease that restricts blood flow from the left atrium to the left ventricle. This restriction means the left atrium has to work harder than usual to send enough blood to the left ventricle, which can cause swelling and inflammation in the vessels of the lungs and increase pressure in the heart, causing shortness of breath.

Mitral regurgitation

Mitral regurgitation is also known as mitral insufficiency. Here, the mitral valve allows blood to flow the wrong way into the left atrium from the left ventricle. The mitral valve is then unable to close properly, causing pressure in the left atrium, which can lead to congestion in the lung vessels.

Without treatment, mitral regurgitation can lead to more serious conditions, including heart failure.

Mitral valve prolapse

In this disorder, the mitral valve does not open and close properly. The condition is common, but in some cases, it can cause significant amounts of blood to leak backward, which is called regurgitation.

Aortic stenosis

This disorder restricts blood flow from the left ventricle to the aorta, causing pressure to increase in the left ventricle. This is because the heart tries to compensate for the restriction so that enough blood reaches the rest of the body.

This overload in pressure causes hypertrophy, a thickening in the walls. The condition may worsen and can lead to angina, heart failure, and syncope.  Aortic stenosis may require surgery.

Aortic regurgitation

In this disorder, the aortic valve does not close properly, which may cause blood to leak back into the ventricle. This causes pressure to increase in the left ventricle, resulting in lung inflammation and swelling. Aortic regurgitation can sometimes result from irregularities in aortic leaflets.

Signs and Symptoms of Heart Valve Disorders

People with heart valve disorders do not always have symptoms, a valve problem can be severe but present no symptoms. In contrast, the condition may be insignificant in terms of leakage but present uncomfortable symptoms.

If a person develops symptoms of a valve problem, they may include the following:

Causes and Risk Factors

Heart valve disorders can develop for several reasons. Some are present from birth, such as:

  • Bicuspid aortic valve: This is an aortic valve with two leaflets instead of three, which may obstruct the opening of the aortic valve or cause leakage backward.
  • Ebstein’s anomaly: This condition causes issues with the tricuspid valve closing properly, allowing blood to leak.
  • Pulmonary valve stenosis: This causes the pulmonary valve to thicken with time, narrowing its opening and making blood flow more slowly.

Sometimes, heart valve disorders develop due to an illness, such as:

  • An injury 
  • Infective endocarditis, an infection of a heart valve, heart lining, or blood vessel
  • Rheumatic fever, an inflammatory condition that can develop after an infection

Disorders can also occur due to age-related factors, such as:

  • Degenerative valve disease: Heart valves can degenerate over time, leading to conditions such as mitral valve prolapse or mitral valve regurgitation.
  • Calcification due to aging: Over time, calcium can accumulate on heart valves, usually affecting the aortic valve, which can lead to aortic stenosis.
  • Mediastinal radiation therapy: Refers to radiation to the chest. Childhood cancer survivors who had radiation therapy may have an increased chance of valve disease later in life.

Diagnosis of Heart Valve Disorders

To diagnose a heart valve disorder, a doctor will first listen to a person’s heart with a stethoscope. If they hear a heart murmur or any other unusual sounds, they may refer the individual to a cardiologist for additional testing.

Cardiologists may help diagnose heart valve disorders with:

  • An echocardiogram, which uses ultrasound to create an image of the heart and the valves and blood flow across them
  • Chest X-ray that can show problems in the structure of the heart
  • A cardiac (MRI),  which creates moving and still images of the heart, allowing doctors to detect problems with its structure and function
  • Electrocardiogram, which measures electrical impulses from a heartbeat
  • An echocardiogram, which uses ultrasound to create an image of the heart and the valves and blood flow across them
  • Stress test, which involves performing an activity while a doctor measures heart performance
  • Cardiac catheterization, which involves placing a catheter inside the heart to assess its health


Treatment of Heart Valve Disorders

Some people with heart valve disorders do not require surgery and can lead healthy lives without symptoms. However, if the condition affects the heart’s ability to work as it should, treatment is necessary.

Treatment will aim to protect the heart from damage, repair or replace the valve, and help someone care for themselves after surgery.

Medications

Medications to manage heart valve disorders can include:

  • Beta-blockers or calcium channel blockers to help control heart rate and blood flow
  • Diuretics to reduce fluid retention
  • Vasodilators to relax the blood vessels and lower blood pressure

Surgery

If a doctor determines a person needs surgery, they may recommend valve repair or replacement.

Surgery interventions to repair the valve aim to preserve the existing valve and leaflets. Sometimes, these repairs require a minor surgical procedure, while they may require more extensive surgery in other cases.

Valve replacement may include minimally invasive procedures or open heart surgery. To complete the operation, a doctor may use an individual’s own tissue, donated tissue, an artificial valve, or an animal valve.

Outlook

People receiving proper treatment for valve disorders generally recover well. However, the outlook depends on the particular valve disorder and its severity and condition of the heart at the time of surgery.

Some disorders, such as mitral valve prolapse, may only require monitoring, while others, such as aortic stenosis, could result in more severe symptoms developing.

Additionally, certain valve disorders may require surgery and ongoing management. A person should discuss any symptoms with their doctor, which may help the healthcare professional discover any serious conditions in the early stages.

Summary

The heart has four valves: aortic, pulmonic, tricuspid, and mitral, and valve disorders can affect any of them. Some disorders cause stenosis, when the valve does not open enough, or regurgitation, when blood leaks back through the valve. Atresia refers to when the heart is missing a valve.

However, not every person with a heart valve disorder has symptoms, and symptoms might not indicate the severity of the disorder. If an individual does have symptoms, they may experience chest pain, palpitations, shortness of breath, swollen feet, ankles, or abdomen, and fatigue. Doctors may also detect a murmur using diagnosis tools.

Treating valve disorders may involve medications, such as beta-blockers, or surgery to repair or replace damaged valves.

 

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