Heart valve disorders

Some heart valve problems are due to birth defects, but most are acquired, due largely to either Rheumatic fever in childhood, or atherosclerosis and degenerative heart disease in later life. Much of this is preventable. In certain specific conditions, or if symptoms cannot be controlled by medication, valve replacement surgery has a high success rate, though some patients may need to use blood-thinning medication for life.

Valves inside the heart keep blood flowing in one direction only- from the right heart chamber to the lungs, and from the left heart chamber to the body. Unless heart valves function normally, blood cannot be kept circulating in this forwards-only direction.

There are four valves inside the heart. Two inlet valves – called Tricuspid and Mitral – open to allow blood to enter the heart’s ventricles (pumping chambers). When they close correctly, blood cannot leak back out during a contraction, and is instead forced out forwards, through the open outlet valves – Pulmonary and Aortic- to go to the either the lungs or the general body circulation.

Regardless of the cause, there are only three basic problems affecting heart valves: they either become narrowed (stenosis) or they become leaky (incompetent) or a combination of the two. Narrowed valves prevent enough blood passing through the opening, whilst leaky valves don’t close properly, allowing blood to leak backwards, instead of flowing forwards.

Valve problems are commonly due to:

• Birth defects
• Infection – rheumatic fever, endocarditis
• Degeneration – e.g. age, Marfan & Barlows syn dromes
• Following a heart attack

Symptoms will vary according to which valve is affected, and whether the valve is narrowed or leaking: shortness of breath, chest pain, palpitations, fainting, ankle swelling and liver enlargement are some possible symptoms. There is usually a heart murmur whose site, nature and intensity will indicate the likely valve problem, which can be confirmed by an Echocardiogram (an ultrasound of the heart, which shows the valves opening and closing).