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Heart Valve Problems
The movement of blood through the heart is regulated by a series of heart valves which ensure that the blood flows smoothly in a single direction.
- What can go wrong with the heart valves?
- What are the symptoms?
- What are the causes of heart valve problems?
- Will I need any tests?
- What treatments are available?
- Living with heart valve problems
What can go wrong with the heart valves?
If any of the four valves are diseased or damaged the flow of blood through the heart is affected and the heart cannot work efficiently enough.
There are two main ways that valves can be affected:
Valves can leak
The valve does not close firmly enough to prevent the blood in the chamber leaking back through the valve. This is called valve regurgitation. The heart has to work harder as it tries to cope with the normal flow of blood as well as the extra blood that has leaked back through the valve.
Valves can narrow
The opening of the valve is narrowed and can not open fully, restricting blood flow between chambers. This is called valve stenosis. The heart has to work harder to overcome this restriction.
Heart valves can leak and narrow at the same time and it is possible for more than one heart valve to be affected.
Both leaking and narrowing valves can place additional strain on the heart muscle. The aortic and mitral valves, on the left side of the heart, are most commonly affected.
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What are the symptoms?
Some people are not aware that they have a heart valve problem because the heart is coping and they don't have any symptoms. However, damaged heart valves increase the workload of the heart and can place additional strain on the heart muscle.
In time, depending on which heart valve is affected and how badly, the following symptoms may appear:
- Shortness of breath
- Ankle swelling
- Increased tiredness
- Chest pain (angina) or palpitations (increased awareness of your heartbeat)
- Dizziness and / or fainting
Your doctor may discover a valve problem when these symptoms are investigated.
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What are the causes of heart valve problems?
Possible causes include:
- Coronary heart disease: this can commonly contribute to a leaky mitral valve.
- High blood pressure: this can commonly contribute to a leaky aortic valve.
- Getting older: age causes the aortic valve to harden and narrow.
- Wear and tear can cause valves to leak.
- Infection can lead to damage causing aortic or mitral leaking. Rheumatic fever during childhood (or teenage years) used to be the main cause of heart valve damage. However, rheumatic fever is now rare in the UK.
- Congenital heart problems: e.g. being born with an abnormal aortic valve can cause aortic regurgitation. Congenital valve problems often do not cause any problems until adulthood, when premature wear and tear may occur.
- Cardiomyopathy (disease of the heart muscle).
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Will I need any tests?
Sometimes a problem with a heart valve is picked up when your doctor, or specialist nurse, listens to your heart through a stethoscope. This can be as part of a routine examination or because you have symptoms such as tiredness, shortness of breath or swelling of the ankles.
If there is damage to a valve then he / she may hear a 'murmur'. This noise is extra to the normal sounds of a heart beat and can be caused by a damaged valve.
Your doctor may refer you to a cardiologist (specially trained heart doctor) for more tests to assess any damage to the valve(s) as well as the general condition of your heart and coronary arteries. These tests can include:
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What treatments are available?
Once a diagnosis of a heart valve problem has been made your doctor will decide what treatment, if any, is best for you.
Any underlying problems (e.g. coronary heart disease and high blood pressure) will also need to be treated.
Monitoring
If the valves are not badly affected and you do not have any symptoms then you may not need any treatment. You will, instead, need regular check ups to see how well the heart is working.
Medical treatment
There are various drugs which your doctor may prescribe to ease the workload of the heart and relieve symptoms.
Surgical treatment
In the longer term your doctor may recommend heart valve surgery to stretch, repair or replace the damaged valve.
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Living with heart valve problems
It is important that you take any prescribed drugs regularly and discuss any troublesome side effects, as well as any new symptoms, with your doctor.
In order to relieve the pressure on your heart it is advisable to try to do what you can to reduce the risk of further heart problems.
As people with heart valve problems have an increased risk of a rare condition called Infective Endocarditis it is advisable to inform your doctor, or dentist, about your condition before you have any invasive treatment. They will assess you and decide if you need to take antibiotics prior to your treatment.
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