Also known as valvular heart disease, heart valve disease is estimated to affect about 600,000 Australians. However, as public awareness of this condition is low, many people living with heart valve disease most likely do not realise, with symptoms often misattributed to normal ageing. If untreated, it can progress to severe complications.
Heart valve disease is a group of heart conditions involving dysfunction of any of the valves in the heart. Blood flows through the heart via four chambers, which are separated from each other by one-way valves. With each heartbeat, the valves open like flaps to allow blood into the next chamber, and then close to prevent blood from flowing backward. Though any valve can be affected, the most commonly involved heart valves are the mitral valve (which regulates blood flow between the left atrium and left ventricle) and the aortic valve (responsible for controlling flow as blood moves from the left ventricle out of the heart into the aorta).
In valvular heart disease, one or more of these valves may become thick or stiffened, restricting the flow of blood through a partially-opened channel. This is known as stenosis.
Heart valve disease may also involve regurgitation, where an inability of a valve to close fully allows blood to leak back into the chamber it came from.
Heart valve disease can be caused by a condition or state that leads to damage or degeneration of the valves. In the case of congenital heart disease, a defective heart valve is present from birth due to a developmental abnormality.
Contributing factors to valvular heart disease can include:
There may also be an inheritable component to heart valve disease, as some types are found to run in families.
Not everyone with valvular heart disease will experience symptoms, which is why the condition often goes undiagnosed. The first sign of a heart valve disease is often a heart murmur, an abnormal sound detected using a stethoscope, but heart murmurs may also be present in people with healthy hearts.
Heart valve disease symptoms can vary in severity between individuals, and may include:
As heart valve disease shares many of its symptoms with other heart conditions, cardiac testing can help to distinguish valvular heart disease from other causes. A physical exam, including listening for heart murmur symptoms, is often followed by other investigations such as an electrocardiogram (ECG), echocardiogram, or chest CT or X-ray.
Determining the underlying cause of valvular heart disease and identifying the specific type of disease are used to guide treatment, which may involve medication or invasive procedures.
Medications may be prescribed to help manage your symptoms to reduce the risk of complications such as blood clotting and stroke, but do not fix a dysfunctional heart valve. Heart valve disease medications may be recommended over surgery if your symptoms are mild, or if you are unable to undergo valve replacement surgery for any reason.
Common medications for valvular heart disease include ACE inhibitors or beta blockers to manage blood pressure, medications for arrhythmia, anticoagulants to reduce the risk of blood clots, or diuretics and vasodilators, which can ease the effort required by your heart when pumping blood.
For some individuals with more advanced valvular heart disease or symptoms that are interfering with their quality of life, a defective valve may need repair or replacement. Common techniques for valve replacement surgery or valve repair include:
Replacement valves may either be mechanical or developed from biological tissue. Each has their own advantages and disadvantages; your cardiologist will discuss the options available to you in a shared decision-making process.
At Harbourside Cardiology, our team is dedicated to providing holistic, patient-centred care that aligns with the most recent clinical guidelines and research. We are with you every step of your health journey, providing continuity of care of all heart conditions from initial assessment through to treatment and recovery.
