Summary about Disease
Valvular heart disease (VHD) occurs when one or more of the heart's four valves don't work properly. These valves (aortic, mitral, tricuspid, and pulmonary) have flaps that open and close, directing blood flow through the heart. VHD can involve stenosis (narrowing of the valve, restricting blood flow) or regurgitation (leakage of blood backward through the valve). VHD can range from mild to severe, and severe VHD can lead to serious complications if left untreated.
Symptoms
Symptoms can vary depending on the severity and which valve is affected. Common symptoms include:
Shortness of breath, especially during exertion or when lying down
Fatigue
Chest pain or discomfort
Dizziness or lightheadedness
Swelling in the ankles, feet, or abdomen
Rapid or irregular heartbeat (palpitations)
Heart murmur (an abnormal sound heard through a stethoscope)
Causes
VHD can be caused by a variety of factors, including:
Congenital heart defects: Some people are born with valve abnormalities.
Rheumatic fever: This inflammatory condition, caused by untreated strep throat, can damage heart valves.
Infection: Infections like endocarditis can damage heart valves.
Age-related changes: Valves can thicken and stiffen with age (degenerative valve disease).
Coronary artery disease: Can lead to mitral regurgitation.
Other conditions: Such as high blood pressure, connective tissue disorders, and certain medications.
Medicine Used
Medications are used to manage symptoms and prevent complications. Examples include:
Diuretics: To reduce fluid buildup.
Beta-blockers, calcium channel blockers, digoxin: To control heart rate and rhythm.
ACE inhibitors, ARBs, Hydralazine, Nitrates: To lower blood pressure and ease the workload on the heart.
Anticoagulants (e.g., warfarin, newer oral anticoagulants): To prevent blood clots, especially in patients with atrial fibrillation or mechanical heart valves.
Antibiotics: To prevent endocarditis in high-risk patients before certain procedures.
Is Communicable
No, valvular heart disease is not communicable. It is not caused by infectious agents that can be spread from person to person.
Precautions
Precautions depend on the severity and type of VHD. General precautions include:
Regular medical follow-up: Consistent monitoring by a cardiologist.
Medication adherence: Taking prescribed medications as directed.
Lifestyle modifications: A heart-healthy diet, regular exercise (as recommended by a doctor), and avoiding smoking.
Antibiotic prophylaxis: Following guidelines for antibiotic use before dental or surgical procedures to prevent endocarditis, if recommended by the doctor.
Managing underlying conditions: Controlling high blood pressure, high cholesterol, and diabetes.
Knowing the symptoms: Recognizing and reporting any worsening symptoms promptly.
How long does an outbreak last?
Valvular heart disease is not an infectious disease and does not involve outbreaks. The disease is chronic and the management is long term.
How is it diagnosed?
Diagnosis typically involves:
Physical exam: Listening to the heart with a stethoscope to detect murmurs.
Echocardiogram: An ultrasound of the heart to visualize the valves and assess their function.
Electrocardiogram (ECG or EKG): To assess heart rhythm and detect any abnormalities.
Chest X-ray: To evaluate the size and shape of the heart and lungs.
Cardiac catheterization: A more invasive procedure used to measure pressures within the heart chambers and assess the coronary arteries (if needed).
MRI: Alternative imaging to assess the heart and surrounding vessels.
Timeline of Symptoms
The timeline of symptoms varies widely.
Congenital VHD: Symptoms may be present from birth or develop in childhood.
Rheumatic VHD: Symptoms may appear years or decades after the initial rheumatic fever infection.
Age-related VHD: Symptoms tend to develop gradually over time as the valves degenerate. Some people may be asymptomatic for years, while others experience symptoms that worsen progressively. Acute changes can occur if the valve suddenly malfunctions due to rupture of supporting structures.
Important Considerations
Severity: The severity of VHD dictates the treatment approach. Mild cases may only require monitoring, while severe cases may necessitate surgery.
Individualized treatment: Treatment plans should be tailored to the individual patient, taking into account their symptoms, overall health, and valve abnormality.
Surgical options: Valve repair or replacement are options for severe VHD. The choice depends on the valve, the extent of damage, and the patient's overall health.
Pregnancy: Women with VHD need careful management during pregnancy due to the increased workload on the heart.
Endocarditis prevention: Strict adherence to antibiotic prophylaxis guidelines (if recommended) before dental or surgical procedures.
Lifelong management: VHD is often a chronic condition requiring lifelong monitoring and management.