Heart Valve Disease: Symptoms, Causes, Tests and Treatment

The heart has four valves that keep blood flowing in the right direction. If one stops working properly, the heart has to work harder. This article explains what the NHS says about heart valve disease. It does not always need treatment, but it does need medical follow-up.

What is heart valve disease?

The NHS describes heart valve disease as a condition where one or more heart valves does not work as it should. It most often affects the aortic or mitral valves on the left side of the heart, and less often the tricuspid or pulmonary valves on the right. The NHS names two main kinds of problem:

• Stenosis: the valve does not open fully.
• Prolapse and regurgitation: the valve does not close fully and may leak.

Either way, the heart has to work harder to pump blood.

Symptoms

Some people have no symptoms, and the condition is sometimes found when a doctor hears a heart murmur. When symptoms occur, the NHS lists:

• Shortness of breath
• Tiredness or weakness
• Dizziness
• Heart palpitations
• Swollen ankles and feet
• Chest pain or discomfort

These symptoms have many possible causes, so they do not confirm heart valve disease.

Causes

The NHS says causes include:

• Congenital heart disease, which is present from birth
• Age-related changes to the heart, with a higher risk in smokers and in people with high blood pressure or high cholesterol
• Conditions such as rheumatic fever, cardiomyopathy or endocarditis
• Damage from a heart attack

The WHO says rheumatic heart disease develops when rheumatic fever scars the heart valves, and that prompt antibiotic treatment of strep throat can prevent rheumatic fever.

How is it diagnosed?

A doctor listens to the heart and may refer you to a cardiologist. The NHS says tests include an echocardiogram (a heart ultrasound), a chest X-ray and an electrocardiogram (ECG).

Treatment and living with it

Valve problems are usually found because of a symptom or because a doctor hears a murmur, and care is planned around how severe the problem is and how it affects you. The NHS says that if the disease is mild and you have no symptoms, you may need no treatment, only regular check-ups. If you have symptoms or severe disease, medicines may be used to lower blood pressure, reduce fluid build-up, slow the heart rate or reduce clot risk. In severe cases, surgery may repair the valve if it is not badly damaged, or replace it with an artificial valve or one made from human or animal tissue. Your specialist decides.

Living with it

The NHS says possible complications include heart failure, atrial fibrillation, stroke and endocarditis. Your care team will advise on what to expect and on lifestyle changes, including avoiding strenuous exercise where needed. Pregnancy can worsen symptoms, so ask a heart specialist for advice before or during pregnancy. The NHS says many people have a safe pregnancy with extra monitoring and treatment.

When to see a doctor

See a doctor, not urgently, if you have regular shortness of breath, tiredness, weakness or dizziness during normal activities, recurring palpitations that last several minutes or are getting worse, swollen ankles or feet, or chest pain that comes and goes.

Call emergency services if you have severe breathlessness, such as choking, gasping or being unable to speak, sudden chest pain that spreads to the arms, back, neck or jaw or lasts more than 15 minutes, or chest pain with shortness of breath or palpitations. Do not drive yourself to hospital, and take your medicines with you.

In an emergency, call your local emergency number (112 in India, 911 in the United States).