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Heart Valve Disease
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Heart Valve Disease• Valvular heart disease• Valves make sure blood flows in a
forward direction– no backward leakage
• Tricuspid and mitral valves• Pulmonic and aortic valves
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Valvular Stenosis• Opening is smaller than normal• Heart may have to work very hard• Conditions
– tricuspid stenosis– pulmonic stenosis– mitral stenosis– aortic stenosis
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Valvular Insufficiency• Same as regurgitation
– Incompetence– Leaky valve
• Conditions– tricuspid regurgitation– pulmonary regurgitation– mitral regurgitation– aortic regurgitation
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Causes• Congenital
• Acquired
• Unknown
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Congenital Valve Disease• Wrong size• Malformed leaflets (flaps)• Attached incorrectly
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Acquired Valve Disease• Problems develop with valves that
were once normal• Changes in structure due to a
variety of diseases or infections– rheumatic fever– endocarditis
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Mitral Valve Prolapse• MVP• Very common
– 1% to 2% of the population• Leaflets of mitral valve flop back
into the left atrium• Rarely causes symptoms• Usually doesn’t require treatment
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Symptoms• Shortness of breath• Weakness or dizziness• Chest discomfort• Palpitations• Swelling• Rapid weight gain
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Symptoms do not always
relate to the seriousness
of the valve disease!!
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MurmurA swishing sound made by
blood flowing through a
stenotic or leaky valve
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Tests• Echocardiogram
– TTE (TT = trans thoracic)– TEE (TE = trans esophageal)
• Cardiac catheterization• Radionuclide scans• MRI
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Goals of Treatment• Protect valve from further damage
• Lessen symptoms
• Repair or replace valve
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Common Medications• Diuretics (water
pills)
• Antiarrhymthmics
• Vasodilators
• ACE inhibitors
• Beta blockers
• Anticoagulants (blood thinners)
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Repair• Percutaneous balloon valvotomy
• Open commisurotomy
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Replacement• Mechanical heart valve
– made from plastic or metal
• Bioprosthetic heart valve– made from human or animal (usually
pig) tissue
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Comparison• Mechanical valve
– More likely to cause clots
– Must take anticoagulants
– Usually for people younger than 70
• Bioprosthetic valve– Does not require
anticoagulants– Not as sturdy– Replace after 10
years– People older than
70
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With either type of valve
replacement, there is a
risk for a heart infection
(endocarditis).