Types of Heart Valve Problems

1. Stenosis (Narrowing of the Valve)
   In stenosis, the valve becomes narrowed, which reduces the flow of blood through the heart. The heart must work harder to push blood through the restricted valve.
   • Cause: Often caused by age-related calcification or damage from conditions like rheumatic fever or infection.
   • Symptoms: Shortness of breath, fatigue, chest pain, dizziness, and fainting, especially during exertion.
2. Regurgitation (Leaking Valve)
   Regurgitation occurs when the valve doesn’t close properly, causing blood to leak backward, which can put extra strain on the heart.
   • Cause: Can be caused by valve prolapse (e.g., mitral valve prolapse), heart attack damage, or infections like endocarditis.
   • Symptoms: Fatigue, shortness of breath, swollen ankles or legs, and a racing or irregular heartbeat.
3. Prolapse (Mitral Valve Prolapse)
   Mitral valve prolapse happens when the mitral valve (between the left atrium and left ventricle) bulges backward into the left atrium during the heart’s contraction. This often leads to mitral regurgitation (leaking).
   • Cause: Genetic or structural issues with the mitral valve.
   • Symptoms: Many people experience no symptoms, while others may have palpitations, chest pain, or dizziness.
4. Atresia (Absent or Underdeveloped Valve)
   Atresia is a congenital condition where a valve, such as the pulmonary valve or aortic valve, does not form properly.
   • Cause: Present from birth due to abnormal development of the heart valves.
   • Symptoms: Cyanosis (bluish skin due to low oxygen levels), difficulty breathing, or poor feeding in infants.

Causes of Heart Valve Problems

Heart valve problems can be caused by several factors, including:

1. Age-related changes: As you age, heart valves can thicken or become calcified, especially the aortic and mitral valves, leading to stenosis.
2. Congenital defects: Some people are born with abnormal valves, such as a malformed or misshapen valve that doesn’t open or close properly.
3. Rheumatic fever: This is an inflammatory disease that can develop after a streptococcal throat infection and may cause permanent damage to heart valves (often the mitral and aortic valves).
4. Infections (Endocarditis): A bacterial or fungal infection in the heart can damage the valves, causing them to become leaky or misshapen.
5. Heart attack: A heart attack can damage the heart muscle, which may also affect the heart valves, leading to conditions like mitral regurgitation.
6. High blood pressure: Chronic hypertension (high blood pressure) can put additional pressure on the heart, causing damage to the heart valves, particularly the aortic valve.
7. Genetic conditions: Some inherited conditions like Marfan syndrome or Ehlers-Danlos syndrome can affect the connective tissue of the heart and its valves, making them more prone to problems like prolapse or regurgitation.

Symptoms of Heart Valve Problems

Not all heart valve problems cause symptoms right away. However, when symptoms do appear, they may include:

• Shortness of breath, especially during exercise or while lying flat.
• Fatigue and feeling tired more easily.
• Swollen feet, ankles, or abdomen due to fluid buildup.
• Palpitations, or an irregular or racing heartbeat.
• Chest pain or discomfort, which may occur with physical activity.
• Dizziness or fainting, particularly during physical exertion.
• Coughing or wheezing, especially when lying down.

Diagnosis of Heart Valve Problems

To diagnose heart valve problems, doctors may use several tools:

1. Physical exam: A doctor may listen for abnormal heart sounds, such as murmurs, using a stethoscope. Murmurs can indicate valve problems.
2. Echocardiogram: This is the most common test used to assess heart valve function. It uses ultrasound waves to create images of the heart’s valves and chambers.
3. Electrocardiogram (ECG or EKG): An ECG records the heart’s electrical activity and can detect abnormal rhythms that might be related to heart valve problems.
4. Chest X-ray: An X-ray can show the size of the heart, which may be enlarged in cases of severe valve disease.
5. Cardiac MRI: In some cases, a cardiac MRI may be used to obtain detailed images of the heart and its valves.
6. Cardiac catheterization: A catheter is inserted into the blood vessels to inject dye and assess the heart valves and coronary arteries. This is typically used if surgery or other procedures are being considered.

Treatment of Heart Valve Problems

Treatment depends on the type and severity of the valve problem. Some people may only need medication to manage symptoms, while others may require surgery to repair or replace the damaged valve.

1. Medications:
   • Diuretics: To reduce fluid buildup.
   • Blood thinners: To prevent blood clots, especially if the valve issue is associated with atrial fibrillation or other complications.
   • Beta-blockers: To slow the heart rate and reduce the heart’s workload.
   • ACE inhibitors or ARBs: To lower blood pressure and ease the heart’s burden.
2. Surgical treatments:
   • Valve repair: In some cases, especially for the mitral valve, the valve can be surgically repaired. This might involve removing excess tissue or repositioning the valve flaps.
   • Valve replacement: If the valve is too damaged, it may need to be replaced with an artificial valve. There are two main types:
     • Mechanical valves: Made of durable materials, but they require lifelong blood-thinning medications.
     • Biological valves: Made from animal tissue or human donors, and they may not require blood thinners, but they may wear out faster.
3. Minimally invasive procedures:
   • Transcatheter Aortic Valve Replacement (TAVR): A minimally invasive procedure used to replace the aortic valve in patients who are not candidates for traditional surgery.
   • Balloon valvuloplasty: A balloon is inflated inside the valve to widen it, typically used in cases of valve stenosis, especially in the mitral or aortic valves.
4. Lifestyle changes:
   • A healthy diet, regular exercise, and avoiding excessive salt can help manage symptoms and prevent further strain on the heart.
   • Monitoring: Regular follow-up with a healthcare provider is necessary for people with heart valve disease, especially if they have undergone surgery or replacement.