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Heart Valve Disease
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Heart valve disease is the third most common cause of heart problems in the United States. The heart circulates blood through the lungs, where it is oxygenated and then pumped out to the rest of the body. Heart valves maintain the forward flow of blood across the heart and through the circulatory system. Because of gender-specific characteristics, women with heart valve disease deserve special attention.

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Heart valve disease is a condition in which one or more of the four heart valves (tricuspid, pulmonary, mitral, and aortic) don't work properly. Heart valves can have three basic kinds of problems: 

  • Regurgitation or backflow: Occurs when a valve doesn’t close tightly. Blood leaks back into the chamber rather than flowing forward through the heart or into an artery. Backflow is most often due to prolapse. "Prolapse" is when the flaps of the valve flop or bulge back into an upper heart chamber during a heartbeat. Prolapse mainly affects the mitral valve, but it can affect the other valves as well.
  • Stenosis: Occurs when the flaps of a valve thicken, stiffen, or fuse together preventing the heart valve from fully opening so an inadequate amount of blood flows through the valve. Some valves can have both stenosis and backflow problems.
  • Atresia: Occurs when a heart valve lacks an opening for blood to pass through. You can be born with heart valve disease or you can acquire it later in life. Heart valve disease that develops before birth is called a congenital valve disease. 

Signs & Symptoms
The main sign of heart valve disease is an unusual heart sound called a heart murmur. Your doctor can hear a heart murmur with a stethoscope. However, many people have heart murmurs without having heart valve disease or any other heart problems. Others may have heart murmurs due to heart valve disease, but have no other signs or symptoms. Other common signs and symptoms of heart valve disease relate to heart failure, which heart valve disease can eventually cause. These symptoms include: 

  • Unusual fatigue (tiredness)
  • Shortness of breath, especially when you exert yourself or when you're lying down
  • Swelling of your ankles, feet, or sometimes the abdomen 

Outlook
Currently, no medicines can cure heart valve disease. However, lifestyle changes and medicines often can successfully treat symptoms and delay complications for many years. Eventually, you may need to have your faulty valve repaired or replaced with a man-made or biological valve. When possible, heart valve repair is preferred over heart valve replacement. Valve repair preserves the strength and function of the heart muscle. People who have valve repair also have a lower risk for endocarditis after the surgery, and they don't need to take blood-thinning medicines for the rest of their lives. To prevent heart valve disease caused by rheumatic fever, see your doctor if you have signs of a strep infection. This infection can cause rheumatic fever, which can damage the heart valves. If you do have a strep infection, take all medicines as prescribed. Mild to moderate heart valve disease during pregnancy usually can be managed with medicines or bed rest without posing heightened risks to the mother or fetus. Your doctor can advise on which medicines are appropriate during pregnancy. Severe heart valve disease can make pregnancy or labor and delivery riskier. If you have severe valve disease and/or its symptoms, consider having your heart valves repaired or replaced before getting pregnant. Such repair or replacement also can be done during pregnancy, if needed. But this surgery poses danger to both the mother and fetus. 


Repairing Heart Valves

Having heart valve repair or replacement depends on a number of factors, including: 

  • How severe your valve disease is.
  • Your age and general health.
Whether you need heart surgery for other conditions, such as bypass surgery to treat CAD. Bypass surgery and valve surgery can be done at the same time. 
When possible, heart valve repair is preferred over heart valve replacement. Valve repair preserves the strength and function of the heart muscle. People who have valve repair also have a lower risk for endocarditis after the surgery, and they don't need to take blood-thinning medicines for the rest of their lives. However, heart valve repair surgery is harder to do than valve replacement. Also, not all valves can be repaired. Mitral valves often can be repaired. Aortic or pulmonary valves often have to be replaced. 
Heart valves can be repaired by: 
  • Separating fused valve flaps
  • Removing or reshaping tissue so the valve can close tighter
  • Adding tissue to patch holes or tears or to increase the support at the base of the valve 
Replacing Heart Valves
Sometimes heart valves can't be repaired and must be replaced. This surgery involves removing the faulty valve and replacing it with a man-made valve or a biologic valve. Biologic valves are made from pig, cow, or human heart tissue and may have man-made parts as well. These valves are specially treated, so no medicines are needed to stop the body from rejecting the valve. 
Man-made valves are more durable than biologic valves and usually don't have to be replaced. Biologic valves usually have to be replaced after about 10 years, although newer biologic valves may last 15 years or longer. Unlike biologic valves, however, man-made valves require you to take blood-thinning medicines for the rest of your life. These medicines prevent blood clots from forming on the valve. Blood clots can cause a heart attack or stroke. Man-made valves also raise your risk for endocarditis. 

 

See also Endocarditis.
Source: "Heart Valve Disease." Diseases and Conditions Index. The National Heart, Lung, and Blood Institute. The National Institutes of Health. 
 

 

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WomenHeart: The National Coalition for Women with Heart Disease is a nonprofit, 501(c)(3) patient advocacy organization with thousands of members nationwide, including women heart patients and their families, health care providers, advocates and consumers committed to helping women live longer, healthier lives. WomenHeart supports, educates and advocates on behalf of the 42 million American women living with or at risk of heart disease. Our programs are made possible by donations, grants and corporate partnerships.

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WomenHeart: The National Coalition for Women with Heart Disease is a founding partner of The Heart Truth Red Dress campaign. The Heart Truth and Red Dress are trademarks of HHS.