How Healthy Are Your Heart Valves?
Your heart has four valves to control the flow of blood within the chambers of the heart, as well as to the rest of the body. But if one of those valves stops working properly, the health complications can become life threatening. Heart failure, abnormal heart rhythms (arrhythmias) and other conditions can result from valve disease.
So how do you know if your heart valves are working optimally, or if your existing valve problems are likely to progress? The keys, according to UCLA Health cardiologist Ravi Dave, MD, are knowing the symptoms of valve disease, and following through with doctor appointments and your physician’s recommendations on medications and other treatments.
“A patient with a heart valve problem should be under close observation of a physician,” he says. “Any new symptoms observed by the patient should be reported to the physician.”
And for people who have no known valve disease, an understanding of how the valves work and what ini-tial symptoms feel like is important.
Common valve ailments
The most common valve problems are aortic valve stenosis and aortic valve regur-gitation, as well as mitral valve stenosis and mitral valve regurgitation. Stenosis refers to a stiffening of the valves to the point where they cannot open all the way. This makes the heart work harder to pump enough blood through those affected valves. Regurgitation means the valves don’t close properly, so some blood that is pumped through the valve may leak backwards, raising the risk of blood clot formation and other problems.
The mitral valve separates the left atrium, an upper heart chamber, from the left ventricle below it. Blood enters the left atrium from the lungs, where it has been oxygenated. After passing through the mitral valve, blood pauses in the left ventricle before it is pumped through the aortic valve and into the aorta, and eventually throughout the body.
Veins bring oxygen-depleted blood from the body into the right atrium. From there it passes through the tricuspid valve down to the right ventricle. When the heart beats, blood is pumped from the right ventricle through the pulmonary valve to the lungs.
Detecting trouble
In mild cases of valve disease, there may be no obvious symptoms. Typically, valve prob-lems are first discovered when a doctor hears an unusual sound, or murmur, when listening to the heart.
“A heart murmur occurs when blood flows through a valve that is narrow or leaking,” Dr. Dave says. “However, heart murmurs may be innocent or benign, occurring in normal patients and in pregnancy.”
If a valve problem is detected, the doctor may order an imaging test to get a better look at the condition of the valves. Echocardiography, which uses sound waves to create a picture of the heart, is among the most common screenings for valve disease. Cardiac magnetic resonance imaging (MRI), which is also non-invasive, uses radio waves and magnets to create an image of the heart at work.
Early stages of valve disease that produce no symptoms often go untreated, though regular check-ups are crucial to monitor changes in the valve. “If you have a common condition like mitral valve regurgitation, your doctor may decide to monitor you,” Dr. Dave says. “The doctor may decide to evaluate you bi-annually or more often depending on the severity of the condition. An evaluation would entail an examination and imaging studies such as echocardiogram.”
If the condition worsens
There are no medications to cure valve disease, though some drugs may help reduce symptoms and complications.
“As the valve condition progresses, patients note a change in their endurance,” Dr. Dave says. “The most common symptoms noted are shortness of breath, chest pains or faint feeling or passing out. Some other symptoms are heart palpitations. As the condition worsens, weight gain and swelling of ankles may be noted.”
If the health of the valve deteriorates to the point where your health and daily functioning is threatened, valve repair or replacement may be in order. Newer, minimally invasive surgical solutions to valve disease are being developed every year, giving encouragement to patients whose quality of life can be easily affected by valve disease.
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