HEART-VALVE DISEASE

General Information

DEFINITION--A complication of diseases that distort or destroy valves of the heart. The heart has 4 valves. The mitral and tricuspid valves (main heart valves) control blood flow into the ventricles. The aortic and pulmonic valves control blood flow out of the heart. The correct functioning of the valves is vital to the efficiency of the heart as a pump.

BODY PARTS INVOLVED--Heart valves (aortic, mitral, tricuspid and pulmonic valves).

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• No symptoms (sometimes).
• Fatigue and weakness.
• Dizziness or fainting.
• Chest pain.
• Shortness of breath.
• Lung congestion.
• Heart-rhythm irregularities.
• Heart murmurs (abnormal heart sounds heard by the doctor through a stethoscope).
• Abnormal blood pressure (high or low).

CAUSES--

Heart-valve disease can be either narrowed valves, which obstruct blood flow (stenosis), or widened or scarred valves, which allow blood to leak backward into the heart (insufficiency). The disorder may be inherited or caused by any of the following:

• Rheumatic fever.
• A complication of strep throat.
• Atherosclerosis.
• High blood pressure.
• Congenital heart defects.
• Endocarditis and intravenous drug abuse.
• Syphilis (rare).
• Self-injected intravenous drugs are a major risk.

RISK INCREASES WITH

• Persons over 60.
• Family history of heart-valve disease.
• Pregnancy.
• Fatigue or overwork.
• Marfan's syndrome.

HOW TO PREVENT

• Obtain medical treatment for diseases that cause heart-valve damage, such as high blood pressure, endocarditis and syphilis.
• Take antibiotics for streptococcal infections to prevent rheumatic fever.
• If you have a family history of congenital heart disease, obtain genetic counseling before starting a family.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood tests.
• ECG, echocardiogram (See Glossary).
• Heart catheterization (See Glossary).
• Angiography (See Glossary).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization.
• Surgery may be recommended to correct a heart valve defect or remove a diseased or damaged valve and replace it by a mechanical one (a valve made from human or bovine tissue, or a human valve from a deceased person). (See Heart-Valve Replacement in Surgery section.)

POSSIBLE COMPLICATIONS

• Infection of the valves.
• Congestive heart failure.

PROBABLE OUTCOME--Depends on the underlying condition. Many complications of valvular disease can be controlled with medication or cured with surgery.

How To Treat

GENERAL MEASURES--

• Tell any doctor, dentist or anesthesiologist who treats you that you have heart-valve disease. Remind those involved, even if you think they know your medical history.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Antibiotics to treat or prevent bacterial infection of abnormal heart valves.
• Antiarrhythmic drugs to stabilize heartbeat irregularities.
• Digitalis medication to strengthen or regulate the heartbeat.
• Anticoagulants after surgery in some cases.

ACTIVITY--As much as can be tolerated. No restrictions are necessary with some forms of heart-valve disease.

DIET--Eat a low-fat, low-salt diet (see Appendix for both).

Call Your Doctor If

• You have symptoms of heart-valve disease.
• During treatment, you develop signs of infection, such as fever, chills, muscle aches, headache, fatigue and a general ill feeling.