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Track 15: Valvular heart disease

Track 15: Valvular heart disease

Sub tracks in valvular-heart-disease :
 Aortic Stenosis, Mitral Stenosis, Mitral Regurgitation, Aortic Regurgitation, Tricuspid Valve Disease, Pulmonary Valve Disease, Valve Prolapse, Rheumatic Heart Disease, Degenerative Valve Disease, Infective Endocarditis, Valve Calcification, Heart Valve Surgery, Valve Repair vs. Replacement, Bioprosthetic Valves, Mechanical Valves, 
What is valvular-heart-disease ?

Valvular heart disease refers to any condition in which one or more of the heart valves are damaged or diseased, leading to abnormal blood flow through the heart. The heart has four valves: the mitral valve, aortic valve, tricuspid valve, and pulmonary valve. These valves open and close to regulate blood flow between the heart chambers and to the rest of the body. When any of these valves become diseased or malfunction, it can lead to problems with heart function.

Types of Valvular Heart Disease:

1.      Stenosis:

    • Valve stenosis occurs when a valve becomes narrowed or stiff, making it harder for blood to flow through. This can increase the workload on the heart, leading to heart failure or other complications. Common types include:
      • Aortic stenosis (narrowing of the aortic valve)
      • Mitral stenosis (narrowing of the mitral valve)

2.      Regurgitation (Insufficiency):

    • Valve regurgitation occurs when a valve doesn't close properly, causing blood to leak backward. This can lead to inefficient blood flow and over time, weaken the heart. Common types include:
      • Mitral regurgitation (leakage of blood through the mitral valve)
      • Aortic regurgitation (leakage of blood through the aortic valve)

3.      Prolapse:

    • Mitral valve prolapse is a condition where the valve's leaflets bulge (prolapse) into the left atrium during the contraction of the heart, leading to leakage. This can sometimes cause mitral regurgitation.

4.      Combination of Stenosis and Regurgitation:

    • Sometimes, a valve may have both stenosis and regurgitation, leading to more severe symptoms and complications.

Common Causes of Valvular Heart Disease:

1.      Rheumatic Heart Disease:

    • This is a complication of rheumatic fever, which can result from a strep throat infection. Rheumatic fever causes inflammation of the heart valves, leading to scarring and thickening, often affecting the mitral and aortic valves.

2.      Degenerative Valve Disease:

    • Over time, valves may become damaged due to wear and tear. Aortic stenosis, for example, is commonly caused by the buildup of calcium deposits, particularly in elderly individuals, leading to narrowing of the aortic valve.

3.      Infective Endocarditis:

    • This is a bacterial infection of the heart valves that can cause damage to the valve structure. It typically affects people with existing valve problems or those with artificial heart valves.

4.      Congenital Valve Defects:

    • Some people are born with abnormal heart valves. For example, a bicuspid aortic valve (a valve with two flaps instead of three) is a congenital condition that can lead to aortic stenosis later in life.

5.      Heart Attacks (Myocardial Infarction):

    • Damage to the heart muscle from a heart attack can also affect the heart valves, especially the mitral valve, leading to regurgitation.

6.      Calcification:

    • The buildup of calcium on the valve leaflets can cause the valve to become stiff and narrow, a condition often seen in the aortic valve as part of the aging process.

7.      Connective Tissue Diseases:

    • Conditions like Marfan syndrome or Ehlers-Danlos syndrome can affect the structure of the heart valves, causing them to stretch and leak.

Symptoms of Valvular Heart Disease:

Symptoms vary depending on the type of valve disease and its severity, but they often include:

  • Shortness of breath, especially during physical activity
  • Fatigue or weakness
  • Swelling in the legs, ankles, or abdomen (edema)
  • Chest pain or discomfort
  • Palpitations or irregular heartbeat
  • Dizziness or fainting
  • Heart murmur (abnormal sound heard during a heartbeat)

Diagnosis of Valvular Heart Disease:

Several tests can be used to diagnose valvular heart disease, including:

  1. Echocardiography: The primary imaging tool for diagnosing and assessing the severity of valvular heart disease. It uses ultrasound waves to create images of the heart’s valves and chambers.
  2. Electrocardiogram (ECG): Measures the electrical activity of the heart to identify abnormal rhythms or signs of heart damage.
  3. Chest X-ray: Helps assess the size and shape of the heart and check for fluid buildup in the lungs.
  4. Cardiac Catheterization: Invasive test to measure the pressure in the heart and assess blood flow through the valves.
  5. MRI or CT scan: These imaging tests may be used to get more detailed pictures of the heart and valves.

Treatment of Valvular Heart Disease:

Treatment depends on the severity of the disease and the specific valve affected. It may include:

1.      Medications:

    • Diuretics to reduce fluid buildup
    • Beta-blockers or ACE inhibitors to reduce the workload on the heart
    • Anticoagulants (blood thinners) to prevent clots in certain conditions
    • Medications to control blood pressure

2.      Surgical Intervention:

    • Valve Repair: In some cases, the damaged valve can be repaired to restore normal function.
    • Valve Replacement: If a valve cannot be repaired, it may need to be replaced with a bioprosthetic valve (made from animal tissue) or a mechanical valve (made from synthetic materials).
    • Transcatheter Procedures: Minimally invasive techniques, such as Transcatheter Aortic Valve Replacement (TAVR), are used to replace a valve without open heart surgery, typically in patients who are not candidates for traditional surgery.

3.      Lifestyle Changes:

    • Adopting a heart-healthy lifestyle, including a balanced diet, regular exercise, and smoking cessation, is crucial for managing symptoms and preventing progression of the disease.