Valve diseases refer to a group of conditions that affect the valves of the heart. The mitral valve, tricuspid valve, aortic valve, and pulmonary valve are four valves in the heart that play an important role in regulating appropriate blood flow through the heart chambers and to the rest of the body. These valves open and close with each heartbeat, ensuring that blood flows in only one direction and preventing backflow. Valve diseases can occur when the valves of the heart do not function properly. There are two main types of valve diseases: stenosis and regurgitation.

Valve Stenosis

Valve stenosis occurs when the valves become narrowed or constricted, resulting in a reduced flow of blood through the valve. This narrowing can be caused by several factors, including calcification of the valve leaflets (calcific stenosis), congenital abnormalities, rheumatic fever, or infections. The most common valves affected by stenosis are the aortic and mitral valves.

In aortic valve stenosis, the narrowing of the valve obstructs the flow of blood from the left ventricle to the aorta, forcing the heart to work harder to pump blood throughout the body. This can lead to symptoms such as chest pain, fatigue, shortness of breath, and fainting. 

Mitral valve stenosis occurs when the mitral valve becomes narrowed, impeding the flow of blood from the left atrium to the left ventricle. This can cause blood to back up into the lungs, resulting in symptoms such as fatigue, coughing, rapid breathing, and swelling of the legs and feet.

Valve Regurgitation

Valve regurgitation, also known as valve insufficiency or incompetence, happens when the valves do not close properly, leading to the backward flow or leakage of blood. The most common valves affected by regurgitation are the mitral and aortic valves.

Mitral valve regurgitation occurs when the mitral valve fails to close tightly, causing blood to leak backward from the left ventricle to the left atrium during contraction. This condition can be caused by mitral valve prolapse, rheumatic fever, infective endocarditis, or heart muscle abnormalities. Symptoms of mitral valve regurgitation may include fatigue, shortness of breath, palpitations, and swelling in the ankles and feet. 

Aortic valve regurgitation happens when the aortic valve does not close properly, leading to the backflow of blood from the aorta to the left ventricle. It can result from congenital abnormalities, infective endocarditis, rheumatic fever, or aortic root dilation. Symptoms may include chest pain, fatigue, shortness of breath, and an irregular heartbeat.

Drugs that Can Cause Valve Disease

  • Ergotamine: Used for the treatment of migraines, prolonged and excessive use of ergotamine has been linked to valvular heart disease, particularly affecting the aortic and mitral valves.
  • Pergolide: This medication, primarily used for the treatment of Parkinson’s disease, has been associated with an increased risk of valve diseases, particularly affecting the aortic and mitral valves.
  • Fenfluramine and Dexfenfluramine: These weight loss drugs, commonly used in the late 1990s as part of a combination called fen-phen, have been associated with the development of fen-phen-associated valvular heart disease, primarily affecting the mitral and aortic valves.
  • Cabergoline: Used to treat hyperprolactinemia and Parkinson’s disease, cabergoline has been linked to an increased risk of regurgitant valvulopathy, particularly affecting the mitral and tricuspid valves.
  • Bromocriptine: Another medication used for the treatment of hyperprolactinemia and Parkinson’s disease, bromocriptine has also been associated with an increased risk of regurgitant valvulopathy, primarily affecting the mitral and tricuspid valves.

Signs & Symptoms

  • Fatigue or weakness
  • Chest pain or discomfort
  • Irregular heartbeat or palpitations
  • Swelling of the ankles, feet, or abdomen
  • Dizziness or fainting
  • Rapid weight gain
  • Persistent cough, sometimes with blood-tinged sputum
  • Decreased ability to exercise or reduced tolerance for physical exertion
  • Bluish tint to lips or skin (cyanosis) in severe cases

Treatment Options for You

  • Medications: Medications can be prescribed to manage symptoms, improve heart function, and prevent complications associated with valve diseases. Examples include diuretics to reduce fluid buildup, beta-blockers to control heart rate and blood pressure, and medications to manage underlying conditions such as high blood pressure or infections.
  • Valve Repair: In some cases, it may be possible to repair the damaged valve without replacing it. This can involve procedures such as valve commissurotomy, which involves separating the fused valve leaflets, or valve repair techniques to address structural abnormalities or leakage. This approach aims to preserve the patient’s own valve tissue and restore normal valve function.
  • Valve Replacement: Valve replacement may be necessary if the valve damage is severe or if repair is not feasible. There are two main types of valve replacements: mechanical valves, which are made of durable materials like metal and require lifelong anticoagulant medication, and biological valves, which are usually made from animal or human tissue and do not require long-term anticoagulation. The choice of valve replacement depends on various factors, including the patient’s age, overall health, and preference.
  • Transcatheter Procedures: In some cases, minimally invasive transcatheter procedures may be an option for valve repair or replacement. These procedures involve inserting a catheter through a blood vessel, usually in the groin, and guiding it to the heart to repair or replace the valve. Transcatheter procedures can be beneficial for individuals who are at high risk for open-heart surgery.
  • Regular Monitoring and Follow-up: Valve diseases often require ongoing monitoring to assess valve function, detect any changes or worsening of the condition, and adjust treatment as necessary. Regular check-ups, echocardiograms, and other diagnostic tests may be recommended to track the progression of the disease and ensure optimal management.

Must Lifestyle Changes

  • Follow a Heart-Healthy Diet: Adopting a well-balanced, nutritious diet is crucial. Fruits, vegetables, whole grains, lean meats, and healthy fats should all be included in your diet. Reduce your saturated and trans fats, sodium, and added sugars intake. Look for a dietician. 
  • Maintain a Healthy Weight: Achieving and maintaining a healthy weight can alleviate strain on the heart and improve cardiovascular health. If overweight or obese, work with your healthcare provider or a registered dietitian to develop a safe and effective weight management plan.
  • Engage in Regular Physical Activity: Regular exercise can help improve cardiovascular fitness and overall heart health. Consult with your healthcare provider to determine the appropriate exercise regimen based on your specific condition and capabilities.
  • Quit Smoking: Smoking is detrimental to heart health and can worsen valve diseases. If you smoke, seek assistance to quit smoking and adopt a smoke-free lifestyle.
  • Manage Stress: Engage in stress-reducing activities such as meditation, deep breathing exercises, yoga, or hobbies that help you relax and unwind.
  • Medication Adherence: Follow your prescribed medication regimen diligently. Take medications as directed by your healthcare provider and inform them of any side effects or concerns you may have.
  • Regular Follow-up and Monitoring: Attend scheduled follow-up appointments with your healthcare provider for regular evaluation, monitoring of valve function, and adjustment of treatment plans as needed.
  • Practice Good Oral Hygiene: There is evidence to suggest that maintaining good oral hygiene and promptly treating dental infections can reduce the risk of infective endocarditis, a serious infection that can affect damaged heart valves.
  • Limit Alcohol Consumption: Excessive alcohol consumption can have negative effects on the heart. If you drink alcohol, do so in moderation as recommended by healthcare professionals.
  • Seek Emotional Support: Living with a valve disease can be challenging emotionally. Seek support from family, friends, or support groups to cope with the emotional aspects of managing your condition.