As blood flows into and out of the heart’s chambers, it passes through tiny biological doorways that ensure everything flows in the proper direction at appropriate intervals. These doorways are heart valves—tissue flaps that open to let blood in and then close to prevent it from flowing backwards. The system works great unless the valve becomes too narrow or doesn’t seal properly.
Valves that fail to work properly can restrict blood flow or allow it to ‘regurgitate’ back into the previous chamber. Aortic stenosis (narrowing of the aortic valve) and mitral regurgitation (a leaky mitral valve) are the most common heart valve diseases. Chest pain, swelling, shortness of breath and fainting are among the symptoms that can occur.
“The causes of valve disease are varied and range from infection, rheumatic fever, abnormal composition of the valves, trauma, risk factors similar to the development of coronary artery disease, or other problems with metabolism,” says Dr. Alan Zajarias, an interventional cardiologist with Washington University Physicians.
Regardless of the cause, heart valve disease usually is discovered either due to the symptoms listed above or by detection of a heart murmur during a physical exam. An echocardiogram can determine the type and severity of heart valve disease, which then determines the course of treatment.
“Just like anything in medicine, there is spectrum of severity,” says Dr. Daryl Jacobs, an interventional cardiologist with St. Luke’s Hospital. “If the problem is mild, there may be no symptoms, and we may decide to monitor it over time instead of treating it right away. In more severe cases, we may need to repair or even replace the valve.”
Fortunately, the techniques and technology used for heart valve repair are proven to be highly successful. “There is a new technology for patients with functional mitral regurgitation,” notes Dr. Anthony Sonn, an interventional cardiologist with Mercy Clinic Heart and Vascular. “It is called the ‘mitra clip,’ which is a minimally invasive way to decrease the leakiness.”
Even for patients who require valve replacement, Sonn says the prognosis is good and there is no decrease in life expectancy. Artificial valves are either made of metal or animal tissue and can be placed in the heart via catheter.
Prevention of heart valve disease follows the same recommendations as prevention of other types of cardiovascular diseases. “So many of my patients are overweight or obese,” Jacobs notes. “In my office, I talk to patients most often about weight loss and salt intake. We only need about 2,000 milligrams of salt daily, but people get much more than that. Too much salt can cause high blood pressure and stiffening of the arteries, which can contribute to heart valve disease.”
If you experience symptoms, don’t simply assume they’re due to aging, Sonn notes. See you primary-care physician for a physical exam and referral to specialists, if needed.