Valvular Heart Disease Oakville
Valvular Heart Disease
What is Valvular Heart Disease?
The heart has four heart valves, that allow blood to flow in the forward direction through the heart. Each of these four heart valves separate the four cardiac chambers, and are designed to prevent the backward flow of blood between these four cardiac chambers.
- Tricuspid valve – located between the right atrium and the right ventricle
- Pulmonary Valve – located between the right ventricle and the pulmonary artery
- Mitral Valve – located between the left atrium and the left ventricle
- Aortic valve – located between the left ventricle and the aorta
The natural flow of blood is such that deoxygenated blood returns to the right atrium, whereby it travels through the tricuspid valve into the right ventricle. The right ventricle pumps this blood through the pulmonary valve into the lungs, to become oxygenated. The oxygenated blood then returns to the left atrium, and travels through the mitral valve into the left ventricle. The left ventricle, which is the main workhorse of the heart, then pumps this oxygen-rich blood out of the heart, through the aortic valve and to the rest of the body.
Valvular Regurgitation
(also called valvular insufficiency)
The valve cusps do not close properly, causing blood to leak backwards into the former cardiac chamber.
Valvular Stenosis
The valve cusps can become calcified, thickened, or possibly fuse together, resulting in a narrowed valve opening, restricting blood flowing forward through the heart.
Valvular heart disease is when one or more of these valves do not open or close properly, causing the natural course of the blood flow through the heart to become disrupted.
Each of the 4 heart valves can have one or both types of valve issues (regurgitation and/or stenosis) and multiple valves can be involved at one time. Mild valvular disease may not lead to significant strain on the heart. However severe valvular disease can lead to the reduction of the heart’s pumping function. This means that less oxygen rich blood will be pumped forward to the rest of the body, and can lead to very debilitating symptoms.
What causes valvular heart disease?
There are many causes of valvular heart disease. Common causes include:
- Changes in the heart valve structure due to aging, such as degeneration or calcification
- History of certain forms of heart disease or a heart attack
- History of bacterial infections in the bloodstream that can affect the heart valves directly
- History of rheumatic fever from strep throat that may not have been treated adequately
- Heart conditions that may have been present since birth (Congenital Heart Disease)
- Thoracic Aortic Aneurysms
- History of high blood pressure, high cholesterol, diabetes, sleep apnea, or other cardiovascular risk factors
- Genetic predisposition (such as myxomatous degeneration: an inherited connective tissue disorder that weakens the heart valve tissue)
What are the symptoms of Valvular Heart Disease?
Unfortunately, many patients do not have symptoms until the valvular disease becomes more severe. It will depend on the type of valve involved, but typically when symptoms do occur they fall into one or more of the following 3 categories:
- Heart failure
- An abnormal heart rhythm (arrhythmia)
- An embolic event (e.g. stroke)
Symptoms of heart failure include shortness of breath, abdominal fullness/distention, coughing at night, swelling of the ankles, and weight gain. A patient may start to feel satiated with smaller and smaller meals, and notice that they need to sleep propped up at an angle using multiple pillows, just to be able to breathe properly. Other symptoms could include fatigue, dizziness, palpitations, and fainting.
Management of Valvular Heart Disease
Management of valvular heart disease, depends on the type and severity of the valvular disease involved. Sometimes, valvular heart disease is just monitored by your cardiologist via a clinical assessment and non-invasive imaging and managed medically. At other times an intervention by an interventional cardiologist and/or cardiac surgeon is necessary. Fortunately in the modern era, having significant valvular disease does not necessarily translate into requiring surgery. There are interventional procedures for certain valves, such as the aortic valve and mitral valve, which can be intervened upon without requiring surgery. This includes the transcatheter aortic valve replacement (TAVR) and the MitraClip® device. Speak to your primary care physician regarding a referral to the Chahal Cardiovascular Centre, to discuss the best options for your particular needs.
Frequently Asked Questions
If any of the symptoms mentioned above occur, you may wish to speak to your primary care physician. Your primary care physician will notice a “Whooshing” sound when they auscultate the chest with their stethoscope during a clinical examination. This is called a heart murmur. Referral to a cardiologist for further testing is imperative if there are signs and symptoms of valvular disease, to gauge the severity and type of disease involved, as this will guide the management strategy.
Severe valvular heart disease can put a strain on the heart, reducing its ability to pump properly. This means, less oxygen rich blood is flowing forward to feed the internal organs of the body. This can inevitably lead to heart failure, an abnormal heart rhythm (arrhythmia) or a stroke, and can be life threatening.
Still have a question about valvular heart disease? Speak to your doctor about a referral to the Chahal Cardiovascular Centre for a cardiovascular consultation.
