Experts characterize heart valve disease as the dysfunction of one or more of the heart's four valves. More than five million Americans receive this relatively common diagnosis every year. In a healthy individual, blood flows one way through the heart: it goes from the top chamber, into the bottom chamber, then to the body. With damaged valves, however, two issues arise. Both regurgitation and stenosis may or may not require surgical treatment.
Our hearts have four different valves—pulmonary, tricuspid, aortic, and mitral. Together, these components ensure the blood in the heart flows strictly in one direction. In general, most problems that arise from valve disease involve the aortic and mitral valve located on the left side of the organ.
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In a healthy heart, blood travels from the right atrium to the left atrium (plural: atria), then enters the left ventricle through the tricuspid and mitral valves. When the ventricles are full, they close; this prevents blood from flowing back into the atria. As the ventricles contract, the aortic and pulmonary valves open, which causes the blood to rush out.
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In most cases, damaged or diseased heart valves cause one of two problems. In stenosis, the valve fails to open fully, restricting or obstructing blood flow. This places extra strain on the heart, as it needs to work harder to pump the blood through the narrowed opening. Because of this, the heart becomes thicker over time; while this helps to build more strength, it can be problematic in the long run as there is a chance that the blood supply to the heart will become insufficient to sustain the extra tissue. Regurgitation is the other potential complication. Blood leaks backward if the valve does not close properly. This also puts extra strain on the heart, as it has to pump harder to deliver the same volume of blood. Eventually, regurgitation can lead to a build-up of fluid in the lungs.
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There are several causes of heart valve disease, one of which involves being born with one or more abnormal valves. Also, the condition can also develop as a complication of rheumatic fever, cardiomyopathy, or endocarditis. Advanced age also increases the risk of developing the disease, as the flexibility or shape of the valves can change over time. Other risk factors include a family history of early-onset heart disease, diabetes, lack of physical activity, and certain autoimmune disorders such as rheumatoid arthritis.
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Most individuals with heart valve disease do not experience any symptoms in the early stages. Nonetheless, prompt treatment is crucial to managing the condition. Some of the common signs include an unusual heartbeat, shortness of breath (especially after physical exercise or lying in bed), unusual fatigue, heart palpitations, dizziness, and swelling in the feet or ankles.
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Diagnosis often occurs after a patient visits the doctor for unusual symptoms. At the clinic, the doctor will perform a physical exam that includes listening to the heart for murmurs. If one is present, confirmation of heart valve disease requires the other tests such as an echocardiogram, EKG, or chest X-ray.
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Depending on the severity of their condition, individuals may or may not require treatment. For instance, it is not uncommon for doctors to simply monitor minor cases with regular follow-ups. If the extent of damage is moderate or severe, the doctor may suggest lifestyle changes such as quitting smoking and maintaining a healthy diet, as well as medications or surgical procedures.
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There are two surgical options for heart valve disease—valve repair and valve replacement. In the former, the physician mends the existing valve, which helps lessen the strain on the heart. More specifically, he or she will fix tears and holes and reshape the tissue. In some cases, the surgeon replaces the entire valve with a man-made alternative or other tissue.
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Many individuals with heart valve disease live long and healthy lives. However, the condition does increase a person’s risk for sudden cardiac death. In rare instances, it can also cause other issues with the heart, such as heart failure, stroke, and rhythm abnormalities, some of which may be fatal without treatment.
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Fortunately, there are quite a few steps we can take to strengthen and protect our hearts, including regular exercise, a heart-healthy diet of vegetables, fruits, whole grains, and proteins, and smoking cessation. In addition to that, it is important to take all medications as prescribed and to practice good dental hygiene, as tooth decay increases the risk of heart infections. People with a history of a heart murmur or valve disease should see a doctor for regular check-ups and always report worsening or new symptoms.
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