Symptoms
Symptoms of VHD can vary depending on the severity of the condition and which valve(s) are affected. Common symptoms include:
Shortness of breath, especially during exertion or when lying down
Fatigue and weakness
Chest pain or discomfort (angina)
Dizziness or fainting (syncope)
Swelling in the ankles, feet, or abdomen (edema)
Heart murmur (an abnormal sound heard through a stethoscope)
Irregular heartbeat (arrhythmia)
Palpitations
Cough
Causes
VHD can be caused by several factors, including:
Congenital heart defects: Some individuals are born with valve abnormalities.
Rheumatic fever: This inflammatory condition, caused by untreated strep throat or scarlet fever, can damage the heart valves.
Infection (Infective Endocarditis): Bacteria or other infectious agents can infect the heart valves, leading to damage.
Age-related changes: Valves can thicken and stiffen over time due to calcium deposits (calcification) or wear and tear.
Other heart conditions: Conditions like coronary artery disease, high blood pressure, or cardiomyopathy can contribute to VHD.
Radiation therapy: Radiation to the chest can sometimes damage heart valves years later.
Certain medications: Some medications have been linked to VHD.
Connective tissue disorders: Conditions like Marfan syndrome can affect the heart valves.
Medicine Used
Medications used to manage VHD aim to control symptoms and prevent complications. They do not cure the valve problem itself. Common medications include:
Diuretics: To reduce fluid retention and swelling.
Beta-blockers: To slow heart rate and lower blood pressure.
ACE inhibitors or ARBs: To lower blood pressure and reduce the workload on the heart.
Anticoagulants (blood thinners): To prevent blood clots, especially in patients with atrial fibrillation or mechanical heart valves. Warfarin and Direct Oral Anticoagulants (DOACs) are examples.
Antiarrhythmics: To control irregular heartbeats.
Antibiotics: To prevent infective endocarditis in at-risk individuals before certain dental or surgical procedures. Note: Specific medications and dosages are determined by a doctor based on the individual's condition.
Precautions
Precautions for individuals with VHD depend on the severity of the condition. General precautions include:
Regular medical checkups: Follow up with a cardiologist regularly.
Medication adherence: Take medications as prescribed.
Healthy lifestyle: Maintain a healthy weight, eat a balanced diet low in sodium, and engage in regular exercise as advised by your doctor.
Dental hygiene: Practice good dental hygiene to prevent infective endocarditis.
Prophylactic antibiotics: Take antibiotics before certain dental or surgical procedures if recommended by your doctor.
Avoid smoking: Smoking can worsen heart conditions.
Manage underlying conditions: Control high blood pressure, high cholesterol, and diabetes.
Notify healthcare providers: Inform all healthcare providers about your VHD.
How long does an outbreak last?
Valvular heart disease isn't an outbreak-related illness. It is a chronic condition that develops over time. However, if infective endocarditis occurs, that infection can last from several weeks to months, requiring prolonged antibiotic treatment. The effects of VHD can last a lifetime if untreated, requiring lifelong management.
How is it diagnosed?
VHD is diagnosed through a combination of:
Physical Exam: A doctor listens for heart murmurs with a stethoscope.
Echocardiogram: This ultrasound of the heart is the primary diagnostic tool. It can assess valve structure, function, and the severity of any leakage or narrowing.
Electrocardiogram (ECG/EKG): This test records the electrical activity of the heart and can detect arrhythmias or signs of heart enlargement.
Chest X-ray: To evaluate the size and shape of the heart and lungs.
Cardiac Catheterization: In some cases, a catheter is inserted into a blood vessel and guided to the heart to measure pressures and blood flow. This is usually done before valve surgery.
MRI of the heart: Can further define valve problems
Timeline of Symptoms
The timeline of VHD symptoms varies greatly:
Congenital VHD: Symptoms may be present at birth or develop in childhood or adulthood.
Mild VHD: Can be asymptomatic for years.
Progressive VHD: Symptoms gradually worsen over time.
Acute VHD (e.g., infective endocarditis): Symptoms develop rapidly. The progression of symptoms depends on the specific valve(s) involved, the severity of the valve dysfunction, and the individual's overall health. Regular monitoring is crucial to detect changes and adjust treatment as needed.
Important Considerations
Valvular Heart Disease and Pregnancy Complications Valvular heart disease poses significant risks during pregnancy. The increased blood volume and cardiac output that occur during pregnancy place extra strain on the heart, which can exacerbate existing valve problems. Important Considerations:
Pre-pregnancy evaluation: Women with VHD should undergo a thorough evaluation by a cardiologist before becoming pregnant to assess the severity of their condition and discuss potential risks.
Risk stratification: Based on the type and severity of VHD, individuals are classified into risk categories to guide management.
Medication management: Some heart medications are harmful during pregnancy and need to be adjusted or discontinued. Warfarin is generally avoided, especially during the first trimester. Heparin or low-molecular-weight heparin may be used instead.
Close monitoring: Pregnant women with VHD require close monitoring by a cardiologist and obstetrician throughout pregnancy. This includes regular echocardiograms and ECGs.
Delivery planning: The mode of delivery (vaginal vs. Cesarean section) is determined based on the individual's cardiac status and obstetric factors. Epidural anesthesia is often used to minimize pain and stress during labor.
Increased risk of complications: Pregnancy in women with VHD is associated with a higher risk of complications, including heart failure, arrhythmias, thromboembolism (blood clots), preeclampsia, premature birth, and maternal death.
Valve replacement or repair: If VHD is severe, valve replacement or repair may be considered before pregnancy, but this is not always possible. Mechanical heart valves require lifelong anticoagulation, which poses challenges during pregnancy. Bioprosthetic valves have a limited lifespan and may require replacement later.
Infective Endocarditis Prophylaxis: Antibiotics before delivery and other invasive procedures may be given.
Contraception counselling: Thorough discussion about contraception options following pregnancy. Disclaimer: This information is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.