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Heart & Vascular Institute

Valve Disease

What is valve disease?

In general terms, valve disease is any functional issue within one of the four valves of the heart: aortic, mitral, tricuspid or pulmonary. Each of these valves directs blood flow between chambers of the heart, to the lungs or to the aorta. If valves do not open and close properly blood flow can affected by narrowing the valve opening or allowing backward flow.

The two most common forms of valve disease are stenosis and regurgitation. Stenosis occurs when a valve is too narrow to allow the proper flow of blood. Regurgitation is also known as a leaky valve, meaning the valve does not close properly. Blood then flows backwards through the valve.
A third type of valve disease known as prolapse is more common with the mitral valve which is located between the left two heart chambers, the atrium and ventricle. Prolapse occurs when the valve is redundant and may not seal completely when it closes. Mitral prolapse is a structural deficiency in the flaps of the mitral valve including enlargement of the flaps or improper length of the strings which control the flaps.

The causes of valve disease range from infections such as rheumatic fever to congenital abnormalities and acquired valve disease.

What are the symptoms of valve disease?

Valve disease can be virtually unnoticeable until your body is receiving significantly low amounts of oxygenated blood from the heart. Most forms of stenosis present symptoms of fatigue, shortness of breath, chest pressure or tightness and mild palpitations or fluttering. One or all of these symptoms may occur in patients with stenosis.

Regurgitation includes similar symptoms to stenosis, but additional symptoms occur specific to the valve affected. Mitral regurgitation is the most common type of regurgitation and includes symptoms of coughing and lung congestion as well as swelling in the legs and feet. Aortic regurgitation presents symptoms ranging from mild heart murmur to severe palpitations as bloods flows in reverse from the aorta back into the left ventricle. Finally, tricuspid regurgitation symptoms include swelling in the legs, feet and stomach and pulsing in neck veins when blood backflows from the lungs into the right ventricle.

How is valve disease diagnosed?

Several tests can be used to determine if you have valve disease and what type it may be. Your doctor may use a transthoracic echocardiogram or a transesophageal echocardiogram both of which will take internal ultrasounds of the structure of your heart including each valve. Additional testing may include a cardiac catheterization which uses catheters to measure pressures and inject dye to visually see leakage of the valves.

How is valve disease treated?

Treatments for valve disease are as varied as the types of the disease. Some valve disease can be treated with medication and consistent monitoring, other types of valve disease require invasive surgery for repair or replacement of affected valves. In some cases Transcatheter Valve Therapy is available for the aortic valve (TAVR). Covenant Health has offered TAVR since January 2014 and has become the first in the region to offer this treatment.

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