Valvular Heart Disease

Overview

Symptoms

Valve disease symptoms can occur suddenly, depending upon how quickly the disease develops. If it advances slowly, then your heart may adjust and you may not notice the onset of any symptoms easily. Additionally, the severity of the symptoms does not necessarily correlate to the severity of the valve disease. That is, you could have no symptoms at all, but have severe valve disease. Conversely, severe symptoms could arise from even a small valve leak.

Many of the symptoms are similar to those associated with congestive heart failure, such as shortness of breath and wheezing after limited physical exertion and swelling of the feet, ankles, hands or abdomen (edema). Other symptoms include:

Palpitations, chest pain (may be mild).
Fatigue.
Dizziness or fainting (with aortic stenosis).
Fever (with bacterial endocarditis).
Rapid weight gain.

Causes

There are many different types of valve disease; some types can be present at birth (congenital), while others may be acquired later in life.

Heart valve tissue may degenerate with age.
Rheumatic fever may cause valvular heart disease.
Bacterial endocarditis, an infection of the inner lining of the heart muscle and heart valves (endocardium), is a cause of valvular heart disease.
High blood pressure and atherosclerosis may damage the aortic valve.
A heart attack may damage the muscles that control the heart valves.
Other disorders such as carcinoid tumors, rheumatoid arthritis, systemic lupus erythematosus, or syphilis may damage one or more heart valves.
Methysergide, a medication used to treat migraine headaches, and some diet drugs may progress valvular heart disease.
Radiation therapy (used to treat cancer) may be associated with valvular heart disease.

Prevention

Get prompt treatment for a sore throat that lasts longer than 48 hours, especially if accompanied by a fever. Timely administration of antibiotics may prevent the development of rheumatic fever which can cause valvular heart disease.
A heart-healthy lifestyle is also advised to reduce the risks of high blood pressure, atherosclerosis and heart attack.
Don’t smoke.
Consume no more than two alcoholic beverages a day.
Eat a healthy, balanced diet low in salt and fat, exercise regularly and lose weight if you are overweight.
Adhere to a prescribed treatment program for other forms of heart disease.
If you are diabetic, maintain careful control of your blood sugar.

Diagnosis

During your examination, the doctor listens for distinctive heart sounds, known as heart murmurs, which indicate valvular heart disease. As part of your diagnosis, you may undergo one or more of the following tests:

An electrocardiogram, also called an ECG or EKG, to measure the electrical activity of the heart, regularity of heartbeats, thickening of the heart muscle (hypertrophy) and heart-muscle damage from coronary artery disease.
Stress testing, also known as treadmill tests, measures blood pressure, heart rate, ECG changes and breathing rates during exercise. During this test, the heart’s electrical activity is monitored through small metal sensors applied to your skin while you exercise on a treadmill.
Chest X-rays.
Echocardiogram to evaluate heart function. During this test, sound waves bounced off the heart are recorded and translated into images. The pictures can reveal abnormal heart size, shape and movement. Echocardiography also can be used to calculate the ejection fraction, or volume of blood pumped out to the body when the heart contracts.
Cardiac catheterization, which is the threading of a catheter into the heart chambers to measure pressure irregularities across the valves (to detect stenosis) or to observe backflow of an injected dye on an X-ray (to detect incompetence).