Summary about Disease
Valvular stenosis is a condition where a heart valve doesn't open fully. This narrowing restricts blood flow through the valve. The heart has to work harder to pump blood, leading to fatigue, shortness of breath, and other complications. It can affect any of the four heart valves: aortic, mitral, tricuspid, or pulmonic, with aortic and mitral stenosis being the most common. Severity ranges from mild, with no noticeable symptoms, to severe, causing significant heart strain and potentially heart failure.
Symptoms
Symptoms vary depending on the valve affected and the severity of the stenosis. Common symptoms include:
Shortness of breath, especially during exertion
Fatigue
Chest pain or pressure (angina)
Dizziness or fainting
Heart palpitations (irregular or forceful heartbeat)
Swollen ankles and feet
Heart murmur (an abnormal sound heard with a stethoscope)
Causes
Congenital heart defects: Some people are born with malformed heart valves.
Rheumatic fever: This complication of strep throat can damage heart valves.
Calcification: Calcium deposits can build up on heart valves, particularly with age, causing them to stiffen.
Other causes: Rarely, stenosis can be caused by radiation therapy, carcinoid syndrome, or certain medications.
Medicine Used
Medications can help manage symptoms and prevent complications, but they don't cure valvular stenosis. Common medications include:
Diuretics: To reduce fluid buildup and swelling.
Beta-blockers or calcium channel blockers: To slow the heart rate and reduce blood pressure.
Anticoagulants: To prevent blood clots, especially in mitral stenosis.
ACE inhibitors or ARBs: To lower blood pressure and ease the heart's workload.
Antibiotics: Used to prevent endocarditis (an infection of the heart valves), particularly before dental procedures.
Is Communicable
No, valvular stenosis is not communicable. It cannot be spread from person to person.
Precautions
Regular medical checkups: Monitor the condition and adjust treatment as needed.
Healthy lifestyle: Maintain a healthy weight, eat a balanced diet, and exercise regularly (as tolerated).
Antibiotic prophylaxis: If recommended by your doctor, take antibiotics before dental procedures or other medical procedures to prevent endocarditis.
Avoid strenuous activity: Follow your doctor's recommendations regarding activity levels.
Manage underlying conditions: Control conditions like high blood pressure, high cholesterol, and diabetes.
How long does an outbreak last?
Valvular stenosis is not an outbreak-related disease. It's a chronic condition that develops over time. The progression of the stenosis can vary from person to person, taking years or even decades to become severe.
How is it diagnosed?
Physical exam: Listening to the heart with a stethoscope can reveal a heart murmur.
Echocardiogram: This ultrasound of the heart shows the structure and function of the heart valves. It's the primary diagnostic tool.
Electrocardiogram (ECG or EKG): This test measures the electrical activity of the heart and can detect arrhythmias or heart enlargement.
Chest X-ray: This can show enlargement of the heart or fluid in the lungs.
Cardiac catheterization: Involves inserting a catheter into a blood vessel to measure pressures within the heart and assess the coronary arteries. It's used when other tests are inconclusive or to plan for surgery.
CT scan or MRI: May be used to further evaluate the heart.
Timeline of Symptoms
The timeline of symptoms is highly variable.
Early stages: Many people have no symptoms initially. The stenosis may be discovered during a routine physical exam.
Gradual progression: Over time, symptoms may develop slowly, such as mild shortness of breath or fatigue.
Worsening symptoms: As the stenosis becomes more severe, symptoms become more pronounced and debilitating. This can include severe shortness of breath, chest pain, fainting, and heart failure.
Acute decompensation: In some cases, symptoms can worsen rapidly, leading to a medical emergency.
Important Considerations
Severity of stenosis: The treatment approach depends on the severity of the stenosis. Mild stenosis may only require monitoring, while severe stenosis may require valve repair or replacement.
Overall health: Other medical conditions can influence treatment decisions.
Valve repair vs. replacement: Valve repair is preferred whenever possible, but valve replacement may be necessary in some cases.
Mechanical vs. biological valve: If valve replacement is needed, the choice between a mechanical valve (requires lifelong anticoagulation) and a biological valve (may need replacement again in the future) depends on factors such as age, lifestyle, and risk tolerance.
Endocarditis prevention: People with valvular stenosis are at increased risk of endocarditis and should follow their doctor's recommendations regarding antibiotic prophylaxis.
Pregnancy: Women with valvular stenosis should discuss pregnancy plans with their doctor due to the increased strain on the heart during pregnancy.