Heart Valve Disease

There are five causes of heart valve disease as follows:

Rheumatic heart disease
Infection of the heart valve with the bacteria "streptococcus" is followed in weeks to months by a delayed inflammatory reaction called "rheumatic fever", resulting in changes of the valve. Damage to the delicate valvular structures can cause narrowing of the valve or failure to close completely, permitting regurgitation (blood backflow) and leading to progressive malformation of the valve.

Degenerative heart disease
Degenerative heart diseases such as degeneration of mitral/aortic valve and mitral valve prolapse lead to regurgitation. Elderly people are vulnerable to calcific narrowing of the aortic valve, in which calcium deposits build up on the valve. Such degeneration usually causes narrowing of the aortic valve or mitral valve regurgitation.

Infective endocarditis
It is an infection of the endocardium, the lining that covers the inner walls of the heart’s chambers and the valves. It occurs when bacteria, fungi or other microorganisms multiply on the valves’ inner lining which eventually cause holes in the valve, distort it and completely disrupt its function.

Congenital heart disease
Problems with the heart valves may be present from birth. 

Specific damage from other cardiac diseases
Valve dysfunction can trigger other cardiac diseases, such as coronary artery disease, which makes papillary muscles become hypoxic or infarct, and then the impaired contractile function of these muscles can lead to a leaky tricuspid or mitral valve.

Possible symptoms of heart valve disease include:

• Shortness of breath or difficulty catching your breath, especially after you have been active or when you lie down flat in bed.
• Often feeling dizzy or too weak to perform your normal activities.
• Pressure or weight in your chest, especially when you are active or when you go out into cold air.
• Heart palpitations or a feeling that your heart is beating irregularly, skipping beats, or flip-flopping in your chest.
• Swelling in your ankles, feet, or belly. Sudden weight gain with possibly as much as 2 to 3 pounds in 1 day.
   

Symptoms can range from mild to none at all and do not always indicate the seriousness of heart valve disease. If you have the above symptoms, it is advisable to get a detailed examination by a doctor early.

Doctor consultation

The doctor will listen to your heart with a stethoscope to hear the valves opening and closing and the rush of blood through them.

Echocardiogram test

The doctor will conduct an echocardiogram test, which uses sound waves to produce detailed images of your heart valves moving as your heart beats, for diagnosis and determination of the severity of the condition in order to draw up the treatment plan.
 

Magnetic resonance imaging (MRI) scan

The doctor will order a magnetic resonance imaging (MRI) scan, which uses a magnetic field and radio waves to get detailed images of the inside of your heart.

Chest x-ray

The doctor will take an x-ray image of your chest to check your heart, its major vessels, and your lungs for abnormalities.
 

Electrocardiogram

The doctor will use an electrocardiogram (ECG) to measure the electrical impulses given off by your heart. An ECG gives your doctor important information about your heart's rhythm and its size.

People with mild heart valve disease only require regular testing and close monitoring. The doctor may prescribe the following treatment for serious cases:

Medication
For patients found with symptoms of cardiac failure or those with a severe narrowing of the heart valve and signs of irregular heartbeat, the doctor may consider relieving the heart’s burden with oral drugs including diuretics (water pills) and digoxin.
 

Surgery

If the patient is confirmed to only have a narrowing of the mitral/aortic valve, the doctor will arrange for a procedure known as percutaneous balloon dilatation (similar to “balloon angioplasty”).
 

Valvulotomy or heart valve replacement surgery may be necessary in severe cases. In heart valve replacement surgery, the damaged valve is replaced by the doctor with one made of synthetic materials or animal tissues. Besides, the operative mortality rate is 3-7%, depending on pre-operative conditions and other risk factors, such as left ventricular function, history of stroke, carotid artery disease and diabetes, etc.

Biological valve

It is made of bovine pericardium (lining of a cow’s heart) or porcine aortic valve tissue. They do not require anticoagulation but only last for 10-15 years and therefore a second operation may be necessary when the valve wears out.
 

Mechanical valve

It is made of titanium and metal, so they are more durable and last for a lifetime. However, they require lifelong administration of anticoagulants (blood thinners) with a 1-2%/year risk of bleeding or stroke.​