The heart is a four chambered pump. The right side delivers blood to the lungs for oxygenation after receiving it from the rest of the body, and the left side receives oxygenated blood from the lungs and delivers it to the body. There are four one-way valves in the heart that ensure blood flows in the correct direction. When normal valves become dysfunctional the condition is known as acquired valvular heart disease.
Classification
Valve problems are typically characterized as either stenosis or regurgitation, according to the National Institutes of Health. Stenosis means the valve is too narrow, so it does not open all the way and restricts the flow of blood. Regurgitation means the valve is loose or floppy, which causes some blood to flow back through the heart in the wrong direction when the heart contracts.
Types
The right side of the heart is composed of an atrium that receives blood and a ventricle that pumps it out to the lungs. The valve separating the right atrium and ventricle is called the tricuspid valve. Tricuspid stenosis is when the valve restricts the normal flow of blood from atrium to ventricle. When the ventricle contracts, blood should flow only towards the lungs. If any flows back into the atrium through a leaky valve, this is tricuspid regurgitation. The same applies to the next three valves. The pulmonic valve separates the right atrium from the vessels leading to the lungs. The mitral valve separates the left atrium and ventricle. Finally, the aortic valve separates the left ventricle from the aorta, which is the major vessel leading to the rest of the body.
Causes
According to the Cleveland Clinic, there are many possible causes of acquired valvular heart disease. Endocarditis, or infection of the heart, is one possible cause. In rheumatic heart disease, the immune system mistakenly attacks the heart valves after a strep infection. Heart attacks can disrupt the supply of blood to the tissues around the valve, making them weak. High blood pressure can put too much strain on the valves. Connective tissue diseases, radiation, and certain drugs may also cause disease of the valves.
Symptoms
Some people may have no symptoms of acquired valvular heart disease, others may rapidly develop symptoms. Sudden mitral regurgitation can cause fluid to back up into the lungs and lead to shortness of breath. General symptoms of acquired valve disease may include shortness of breath, chest pain, fatigue, fainting, heart palpitations or swelling. Even if no symptoms are noticeable, the Texas Heart Institute notes that over the long term valve disease can cause irregular heartbeats, blood clots, heart muscle diseases, or congestive heart failure, where the heart does not effectively pump blood and there is a buildup of blood and fluids in the body.
Diagnosis
In addition to a history of typical symptoms, listening to the heart with a stethoscope can reveal a murmur as blood flows abnormally through the heart. Echocardiography involves using ultrasound to see the heart and the blood flow through the valves. Cardiac catheterization involves using dyes and x-rays to look at the heart and the blood flow. Chest MRI can also be used to look at the heart, and ECGs monitor the electrical activity.
Treatment
Valve diseases can be treated with medications or surgery. Medications often change the fluid levels in the body to reduce strain on the valves. Surgery may fix a valve that is collapsing, dilate a narrow valve, or replace the valve with a pig valve or synthetic valve according to the Society of Thoracic Surgeons.
