MHVI Owners Manual . Conditions . Valve Disorders

What Are They?
In the Anatomy and Physiology section of this manual, you learned that there are four valves in the heart. Please review the illustration in that section as a reminder. The valves' job is to keep blood flowing in the right direction as it passes through the four heart chambers. The valves and their locations, in the order of normal blood flow, are as follows:

The tricuspid valve lies between the right atrium and right ventricle.
The pulmonic valve lies between the right ventricle and pulmonary artery.
The mitral valve lies between the left atrium and left ventricle.
The aortic valve lies between the left ventricle and aorta.

A valve disorder occurs when one or more of the valves doesn't open or close properly. These malfunctions can take different forms. In the first malfunction, the valve becomes hardened or stiff and can't open or close easily. The valve's difficulty in opening makes it harder for blood to flow from one chamber to the next. This valve problem is called stenosis. Any of the four valves can become stenosed, but the most common disorders are aortic stenosis and mitral stenosis.

Valve disorders can be congenital (present when you are born) or can be the result of rheumatic fever or other infections. Sometimes, as you get older, a valve may degenerate or simply wear out or become thickened with calcium deposits. The result of both advanced stenosis and insufficiency is that the heart cannot generate enough forward output, often resulting in congestive heart failure.

A second type of valve disorder results in a backward flow of blood across the valve and is called regurgitation or insufficiency. In this disorder, the valve becomes too loose or floppy or doesn't close tightly enough, allowing blood to flow backward in the wrong direction. Sometimes a valve that has regurgitation or insufficiency is referred to as a leaky valve. Like stenosis, regurgitation can occur through any of the four valves, but the most common problems that require treatment are mitral regurgitation and aortic regurgitation.

A very common valve problem is mitral valve prolapse (MVP). In this condition, one (or both) of the two leaflets that forms the mitral valve is "floppy." The valve's "floppiness" often allows a small flow of blood back across the valve (mitral regurgitation). Mitral valve prolapse is usually benign, causing few, if any, problems. Occasionally, it can be associated with symptoms and, on rare occasions, it can require surgery later in life.

Besides the problem of blood flow across a diseased valve, there is one additional problem that your doctor will want to prevent. The abnormal flow often results in an increased risk of valve infection, a condition called infective endocarditis. Ask your doctor if you should take antibiotics before procedures such as dental work or surgery. If you have been told you have a valve problem or significant heart murmur, you should tell your dentist. This is very important.

Symptoms
Symptoms of heart valve disorders are similar to those of several other heart conditions. These symptoms include:

Shortness of breath that, in severe cases, may even occur when you are lying down
Weakness and fatigue
Dizziness
Swelling of the feet and ankles
Irregular heartbeats or palpitations
Chest discomfort

Treatment

If you have a mild valve disorder, your doctor may simply check your heart on a regular basis without any additional treatment.
At other times, a valve disorder may be treated with medications that increase your heart's efficiency, control irregular heartbeats, decrease excess fluid, or control high blood pressure.
For more serious valve symptoms, surgery to either repair or replace the mal-functioning valve may be recommended.

With any of these approaches, lifestyle changes will be an important additional treatment.

A diet low in sodium will help control extra fluid your body might retain, and a diet high in fiber and low in fat and sugar will help your overall cardiovascular health.
If you are a smoker, you will need to quit as quickly as possible to prevent further damage to the heart in general.
An exercise program that gradually increases your endurance will also be important.
You will need to monitor and regulate high blood pressure and abnormal blood cholesterol levels.

These measures can help improve how you feel day-to-day and improve your exercise tolerance. More information on all of these strategies is found in the Lifestyle Management section of this manual.