What is a heart valve disease/heart blockage?
In order to understand heart valve disease, it is important to understand how the heart valves work.
How do the heart valves work?
The heart valves are responsible for ensuring that blood flows unidirectionally in the body. There are four heart valve types; aortic valve, pulmonary valve, mitral valve, and tricuspid valve. Initially, blood flows from the atria; the right and the left. The blood flows to the ventricles with the help of the mitral and tricuspid valves which are open to allow blood flow. These valves close when the ventricles are full of blood. This closing ensures that the blood does not flow back to where it came from. The ventricles then begin to contract and this is when the aortic and pulmonary valves are opened in high pressure. This is done to pump the blood out of the ventricles.
The blood that is inside the right ventricle goes from the pulmonary valve into the pulmonary artery. The blood that is inside the left ventricle goes from the aortic valve, which is now open, inside the aorta and then the rest of the body. Once the contraction of the ventricles is completed, the pulmonary valve and aortic valves close. These ensure blood cannot flow back inside the ventricles or there is no heart valve leakage. This process takes place every time your heart beats and this is how blood is supplied to your body, lungs, and your heart.
How does Heart valve disease hamper heart function?
Heart valve disease is commonly referred to as heart block colloquially. It is a condition where one or more of the four valves of the heart do not operate properly. There are two types of heart valve disease.
Valvular incompetence is one type of heart valve disease. It is also called insufficiency, a leaky valve, and regurgitation. This occurs when the valve does not close properly due to which blood goes back into the ventricles. When the state of the leak becomes worse, it affects the ability of your heart to properly pump blood to your body. That is because your heart needs to put in more effort and as a result, less blood is available to be pumped to the rest of your body. There are specific names given to the condition depending on which valve is leaking. For example, pulmonary regurgitation is when the pulmonary valve is leaking.
The other type of heart valve disease is valvular stenosis. In this condition, one of the valves is unable to open completely to allow blood to flow through. This can be due to stiffness. Since the valve is now narrow, less blood flows through and your heart must do more work as a result. Depending on which valve is causing this problem, there are different names for every valve. If the mitral valve has narrowed then it is called mitral stenosis. If the tricuspid valve is causing the problem then it is known as tricuspid stenosis.
Heart valve disease symptoms
Heart valve disease/blockage symptoms include the following.
- You might be unable to do your daily activities even if they are not strenuous at all. You might start to feel weak. You might even feel dizzy sometimes and suffer from bouts of fainting.
- You might start to experience inexplicable weight gain despite not doing anything out of the ordinary. You can gain up to three pounds in a single day.
- You may feel like there is pressure in your chest. The discomfort can be too much to bear and you might even feel like there is a weight pressing down on your chest.
- You might have difficulty breathing under normal conditions. You might notice this even when you try and rest by lying down on your bed. You might be out of breath easily.
- You might notice swelling in certain parts of your body such as your abdomen and feet. You might feel bloated.
- You might feel like your heart is beating rapidly or your heart is not beating in a normal rhythm. You might feel like you are skipping heartbeats frequently.
Possible causes and risk factors that lead to heart valve disease
Numerous causes and risk factors can lead to heart valve disease and some of them are as follows.
Acquired valve disease occurs when the valves that operated properly once do not do so anymore. The reason is that the structure has changed because of infections such as rheumatic fever or endocarditis. Rheumatic fever is caused by a bacterial infection that was not treated. Generally, it can be caused by strep throat. Rheumatic fever causes the heart valves to inflame and it usually affects children. Symptoms of rheumatic fever are not apparent until 20 years later.
Endocarditis is when heart valves are attacked by bacteria that make their way into your bloodstream. This can be when you have a severe infection, are getting a dental procedure done, or you get a surgery done. These bacteria cause scarring and can damage the valves by making holes in them. This usually leads to leaky valves.
Congenital valve disease usually affects either the pulmonary valve or the aortic valve. In this case, the valves are not properly formed or there is something wrong with the way the valves are attached. This type of disease can occur before birth when the formation of the heart is taking place. Congenital heart valve disease can occur with other types of congenital heart defects or it can occur by itself.
Mitral valve prolapse, also known as MVP, affects up to 2% of people all over the globe and it affects the mitral valve. It causes the mitral valve to leak because it makes the valve tissues stretch more than normal. Mitral valve prolapse makes the mitral valve to go back into the left atrium. This occurs when the heart is contracting.
Bicuspid aortic valve disease is a type of congenital heart valve disease. This particularly affects the aortic valve in your heart. In a normal cusp, there are supposed to be three cusps but in this case, there are only two cusps. Two problems can occur. Either the valve is unable to open or close due to the missing third cusp. Else, the valve becomes leaky in which case it cannot close as tightly as it should.
Apart from the causes above, heart valve disease can be caused by syphilis, heart attack, high blood pressure, cardiomyopathy, aortic aneurysms, coronary artery disease, and connective tissue diseases. Metabolic disorders, carcinoid syndrome, and autoimmune disorders can also cause heart valve disease. Sometimes, heart valve disease can occur due to some types of medications, radiation, and tumours although rarely.
How is heart valve disease diagnosed?
Your doctor will ask you about your symptoms first. Then a physical exam will be performed by your doctor. In this, your doctor will listen to your heartbeat and determine whether your heart is beating as it should. If there are any irregularities in the way your heart is beating, then your doctor will know that something is not right. Your doctor will particularly listen to the sound of your heart when the valves of your heart are opening and closing. Heart murmurs are abnormal noises that are caused by the turbulent flow of blood caused by structural defects in your heart.
Murmurs are produced by one of your valves becoming narrowed or when there is a leaky valve in your heart. Your doctor, through the physical exam, can tell if your heart has enlarged or not. Your doctor will listen to your lungs too. This is to determine if there is a fluid that is present in the lungs. If this is the case then it tells the doctor that your heart is unable to pump as efficiently as it normally should. With the help of the tests, your doctor can determine how well your organs are functioning and how well the blood circulation is taking place.
Once the physical exam has been completed, other tests such as the following may be performed. Echocardiography is a test that is used to analyze your heart valves and heart muscle with the help of ultrasound. This test can be used to check on how the heart valve disease is progressing after treatment. There are various types of such tests and your doctor will determine which type you test is best for your case.
Angiogram or cardiac catheterization is another test that can be performed to diagnose heart valve disease. The test uses a catheter to be inserted into one of your blood vessels. It allows your doctor to determine whether blood vessels are supplying blood to the heart. It is an invasive procedure. It is used by your doctor to analyze how well your heart muscle is functioning. The test is used to decide whether you need to get treated and to confirm that you have a heart disease such as heart valve disease or coronary artery disease.
Treatment and surgical intervention in case of heart valve disease
The treatment for heart valve disease depends on how serious the condition is in your case. Regardless of which type of heart valve disease you have and the severity of it, the treatment is used to protect your heart valves so they are not damaged further.
In addition, the treatment is used to give you some relief by managing the symptoms and repair or replace the heart valves depending on the severity. Here is how the three are done.
When you are diagnosed with heart valve disease your chances of having endocarditis increase. You need to protect yourself by letting your doctor and dentist know that you have heart valve disease. You should start taking more care of your teeth and gums so that you don’t get any infections. If you feel like you have symptoms then you should call your doctor immediately. Be on the lookout for symptoms such as body aches and sore throat. Your doctor can tell you about specific medications before any major procedure is needed.
There are medications that your doctor will prescribe to treat the symptoms that you have. These are used to decrease the chances of your heart valve damage from getting worse. Some need to be taken for as long as you live while others can be stopped once you have had surgery done. Your doctor might prescribe medications such as antiarrhythmic medicines, ACE inhibitors, diuretics, anticoagulants, vasodilators, or beta-blockers. You should ensure that you know exactly when and how to take your medications. You should keep a record of the medication-related information with you safely in a medical journal.
You might require a surgery to be performed for repairing your heart valves or replacing your heart valves. Your doctor can use traditional heart valve surgery. In this type of surgery, you will be sedated for the length of the procedure. Then the surgeon will make an incision in the centre of your breastbone making it easy for him to reach your heart. Then, the surgeon will repair or replace the heart valves inside your heart. Your doctor might recommend a minimally invasive heart valve surgery or laparoscopic which is done with the help of small cuts. You need to be a good candidate for this procedure so that your doctor can perform it.
A transesophageal echo will be used before and after the heart valve surgery. This will enable your doctor to see how well the heart valve that has been repaired is working. The transesophageal echo enables your surgeon to take a complete look in your heart and the blood vessels as well. Most patients prefer this type of surgery. The benefit of minimally invasive heart valve surgery is that there will be less blood loss than normal heart valve surgery. In addition, the trauma will be decreased. You won’t have to spend a lot of time in the hospital either which is a major plus.
Many procedures come under heart valve repair surgery. The procedure that is best suited for your case has to be determined by the doctor after a thorough diagnosis. For example, decalcification is for those patients who have calcium deposits in the cusps. In this procedure, the calcium deposits are removed so that the cusps close as they normally should. Other heart valve repair procedures include reshaping of cusps, chordal transfer, patched leaflets, commissurotomy, and annulus support.
When your doctor sees that your heart valves cannot be repaired then he will recommend heart valve replacement surgery. This is usually the case when you have pulmonic valve disease or aortic valve disease.
Heart valve replacement procedure is necessary when repairing is not an option. The surgery involves removing the valve that has been damaged or is not working properly and then sewing a new valve to the tissue that it was attached to earlier. The new valve can be biological, mechanical, or homograft. Biological valves or bioprosthetic valves can last for up to 17 years and these are made from animal or human tissue.
Biological valves do have some parts attached that are artificial to ensure that they can be placed in your heart easily. One of the artificial heart valve types is mechanical valves are also known as bi-leaflet valves. These are specifically designed so that they can be used for a long time to come. The prosthetic heart valve is designed so that your body will accept it readily. Homograft valves are also known as allograft valves. These valves are derived from a human’s heart which has been properly preserved under the right conditions.
Living with heart valve disease
When you know that you have a heart valve disease, you need to ensure that you are safe from problems that can arise later in your life. You should understand what type of heart valve disease you have. You must be aware of the problem that you have. You should ensure you are taking care of your teeth and your gums. If you know that you are going to have surgery then you should ask your doctor about which antibiotics you can use so that you stay protected. Your doctor will prescribe medications and you must follow the instructions properly without fail.
You should regularly see your doctor. A routine check-up is vital especially if you are diagnosed with heart valve disease. Your doctor will recommend how often you should get a check-up. Your doctor needs to see how the heart valve disease is progressing so that if it is worsening then appropriate treatment can be given to you. Whenever you feel like you have symptoms, whether old or new, you should immediately call your doctor. You should especially be careful when you are having weakness, swelling, breathing issues, chills, and fever. This is because these symptoms indicate you might have heart infection.
One of the most important aspects to keep your heart healthy is to exercise. Make exercise a priority rather than something you only do when you have the time. You should speak to your doctor about the exercises you can safely do. Doctors generally recommend exercising for at least 30 minutes daily. If you are overweight or obese, then you need to focus on decreasing your weight the healthy way. Strength training twice a week and a total of 150 minutes of vigorous aerobic exercise each week is a great start. Exercise will decrease your chances of having other heart-related problems.
Maintaining a healthy lifestyle is important. This is why being mindful about your diet is something you should give serious thought to. You should eat green vegetables and fruits such as oranges, prunes, grapes, bananas, and apples. You should eat protein-rich foods and whole grains. You should choose fat-free dairy products or low-fat alternatives whenever you are shopping for dairy products. You can have foods that have high levels of polyunsaturated and monounsaturated fats.
You should reduce sodium consumption. You should limit the intake of foods that have saturated and trans fats. You should avoid having snacks, sweets, sweetened drinks, and alcohol. Since how much you should eat depends on your age, sex, fitness, and body, your doctor can help guide you. Apart from this, you should quit smoking and manage your stress levels. Stress contributes more to heart disease than many people realize and you want to ensure that you are taking measures to ensure you decrease your stress levels.
Road to recovery and aftercare
Once you have had your heart valve surgery, it may take up to eight weeks for you to recover from it. If you had a minimally invasive heart valve surgery then the time to recover may be much less. After your heart valve surgery usually you can start to take care of yourself.
Doctors encourage that you breathe deeply and start to drink, walk, and eat without any aid. In the weeks that follow your surgery, you will be able to get back to your daily activities and you will feel much better as you will regain your usual energy levels. Your regular check-ups will continue after the surgery to ensure things are as they should be.
Your doctor will help you through the road to recovery and aftercare but make sure you ask questions if you have any. For example, you might want to ask about how you can make your recovery as pain-free as possible. You might want to know about how you can change your diet so you can recover faster and heal quicker.
You may want to ask your doctor about how much exercise you can do daily and what types of exercises you should avoid after you get surgery performed.
You should ask about when you can safely drive your vehicle, how long you should rest, and how much weight you can lift without injuring yourself. You want to ensure that you are carefully getting back to your normal activities because you don’t want to put a strain on any of your body parts. It will only delay the recovery process. This is why speaking to your doctor and asking any questions that may arise is a good idea.
Heart valve disease FAQs: All your concerns addressed
Q. Which age group is most likely to get heart valve disease?
A. It is more prevalent in elderly individuals, although it can happen to people who are healthy as well. The reason it happens to elderly individuals is that as we age, the heart valves become stiffer due to calcium deposits. This increases the chance of having a heart valve disease.
Q. What is the best way to prevent heart valve disease?
A. Since there are times that no symptoms will appear until people have severe heart damage, it is a good idea to get regular health checkups. Even if you have symptoms that may seem only mildly inconvenience, there is nothing wrong with getting yourself checked just to be sure.
Q. Are there any methods that do not involve surgery for treating heart valve disease?
A. Yes. A non-surgical option that can be used for heart valve disease treatment is balloon valvuloplasty or valvotomy. This procedure is used to make the narrow valve wider. It is recommended for people with aortic stenosis who can’t have surgery, people with mitral valve stenosis, and people with pulmonic stenosis.
Q. How can I prepare for my leaky heart valve surgery?
A. You will know about your surgery at least a few weeks in advance by your doctor. You want to be healthy before the surgery is performed. As soon as you can, start to eat healthily and make sure you get enough rest. You should exercise as well and minimize stress as much as possible. You can ask your doctor about supplements or medicines you can take.
Q. What happens during surgery for heart valve disease?
A. A heart valve surgery is performed when at least one of your four heart valves, namely mitral valve, tricuspid valve, pulmonary valve, and aortic valve stop working properly. In a heart valve surgery procedure, you’ll first be given an anaesthesia. Then you’ll be connected to a heart-lung bypass machine which helps keep the blood pumping blood throughout the procedure. It can be performed using both open-heart surgery or a minimally invasive surgery. A minimally-invasive surgery uses long instruments and lesser incisions whereas an open surgery will involve cutting your chest open through your breastbone. During the procedure, your doctor may also recommend heart valve repair as this helps in preserving the heart function.
Q. What factors can lead me to have a heart valve disease?
A. A heart valve disease occurs when any one of the four valves of the heart i.e. mitral valve, tricuspid valve, pulmonary valve, and aortic valve doesn’t open or close properly causing a disruption in the blood flow. A heart valve disease can either be congenital or can occur as a result of the following:
Some of the risk factors that can increase the chances of a heart valve disease are old age, history of blood pressure and cholesterol, and congenital heart conditions from birth.
Q. What are the surgical options I have to treat a heart valve disease?
A. The treatment options for heart valve disease depend on the severity of your condition. Your cardiologist can monitor your symptoms and suggest the right treatment option for you. The different surgical options for heart valve disease are:
- Heart Valve Repair - This helps preserve your heart valve and heart function.
- Heart Valve Replacement - In case the heart valve can’t be repaired, then your doctor may suggest a heart replacement.
- Lifestyle and home remedies - Heart-healthy lifestyle choices such as proper diet, exercise, avoiding smoking and alcohol, and managing stress.
Q. How can a heart valve be repaired?
A. A heart valve repair is generally recommended by doctors since it helps preserve the valve and maintains the heart function. During the repair process, surgeons separate the flaps, replace the cords that support the valve, and remove excess tissues that can obstruct the closing of the valves. In some cases, the surgeons also tighten the annulus or the ring around the valve by planting an artificial ring.
Q. Is it possible to replace my heart valve?
A. In case a heart repair won’t work, surgeons may decide to replace your heart valve. So the surgeon may remove your damaged valve and replace it with a mechanical valve made from animal or human tissue. If you’ve received a mechanical valve, then you may need to take blood-thinning medications to prevent a blood clot. To understand which valve will be right for you, it’s best to consult your doctor.
Q. What complications and risks should I know about before my heart valve surgery?
A. In case you plan to get a heart valve surgery done, there are certain risks and complications you need to keep in mind. The risks are:
- Old age
- History of infections afflicting the heart
- History of any form of heart attack
- High blood pressure, cholesterol, diabetes, and heart disease
- Congenital heart disease at birth
The complications include:
- Heart failure
- Blood clots
- Abnormalities in heart rhythm
Q. How long will an artificial heart valve last?
A. As per research, mechanical valves have been found to last for 25 years and tissue valves have been found to last for 15 years without any issues.
Q. How many heart valves do a human heart have?
A. Valves are flaps that act as one-way inlets for blood coming into a ventricle and one-way outlets for blood leaving a ventricle. Normal valves have 3 flaps except the mitral valve which only has 2 flaps. There are four heart valves where humans have a mitral valve and tricuspid valve, and aortic valve, and pulmonic valve.
Q. Should I expect an immediate improvement in my health after heart valve repair or replacement surgery?
A. The results of repair or replacement surgery vary from individuals to individuals. Many patients witness improvement in the heart blockage symptoms post the surgery. It is important to talk to a doctor to gauge your progress following the heart blockage treatment.
Q. Do I need to take medications post heart valve replacement or repair surgery?
A. You may be required to take medications post-surgery. There are different heart valve surgery, and you may need blood thinners in some cases such as after mechanical valve replacement surgery, while tissue valves do not require you to be on blood thinners for the rest of your life.
Q. I am pregnant. Can I still go for a valvuloplasty?
A. Discuss with your doctor as there may be some risk due to radiation exposure during pregnancy. Also, tell your doctor if you are lactating or breastfeeding.
Q. How can I care for my aortic valve?
A. Here are simple lifestyle measures you can adopt to prevent heart valves disease.
- Eat a heart-friendly diet
- Manage your blood pressure level
- Keep your teeth and gums healthy
- Quit smoking
- Get to know about the heart murmur