Do you sometimes feel tired or dizzy when climbing stairs? We often think that these are normal things that happen as we get older or because we work too hard. But sometimes, behind these small symptoms, there may be a health problem that we need to pay attention to. One such problem is heart valve disease. Don't worry, we will talk about this all in a very simple way that you can understand.
What is Heart Valve Disease?
Simply put, this is a condition where one or more of the valves in our heart do not work properly. Think of our heart as a small house with four rooms. Between these rooms there are four doors that help keep blood flowing in only one direction. Those doors are called valves .
When the heart beats, this valve opens and closes, like a door.
- This valve opens when blood needs to flow forward.
- These close when the blood needs to stop flowing backward.
When this process doesn't work properly, the heart has to work harder to pump blood. If left untreated, this condition can become serious over time. But the good news is that there are many good treatments available today. These valves can be repaired with surgery or other modern methods, or a new one can be installed.
There are four main valves in our heart:
- Mitral valve: Between the left atrium and the left ventricle.
- Tricuspid valve: Between the right atrium and the right ventricle.
- Aortic valve: Between the left ventricle and the aorta.
- Pulmonary valve: Between the right ventricle and the pulmonary artery.
What are the main types of valve diseases?
Valve problems can be divided into several main types. Sometimes the same person can have more than one of these types of problems. Let's see what they are.
| Condition name | Simply put, what happens? |
|---|---|
| Stenosis | The valve leaflets become thick, stiff, and do not open properly. Like a rusty door. This narrows the opening through which blood flows. The heart has to work harder to push the blood forward. |
| Regurgitation | The valve flaps do not close properly, allowing blood to leak backward. This is also called a "leaky valve." It's like air coming through a door that isn't closed, and blood is leaking backward. This causes the heart to work twice as hard. |
| Prolapse | This particularly affects the mitral valve. Because the valve leaflets are too stretchy, they fold backward, toward the left atrium, when the heart beats. This is harmless for most people, but for some it can cause regurgitation. |
| Atresia | This is a congenital condition. A heart valve that forms without an opening while the baby is still in the womb. This is usually diagnosed by doctors at birth. |
What are the symptoms of valve disease?
Many people with valve disease do not show any symptoms in the early stages. However, as the condition becomes more severe over time, symptoms begin to appear as the heart has to work harder.
The important thing is that in many cases, the disease can be present inside the body without any symptoms. Therefore, regular medical tests are very important.
The main symptoms seen are:
- Fatigue: This may be the first symptom you notice. You may feel tired even after doing a little work.
- Shortness of breath (dyspnea): Dyspnea increases, especially when exercising, climbing stairs, or doing any strenuous activity.
- Changes in the way your heart beats (palpitations): You may feel like your heart is beating rapidly, with a "pounding" sensation in your chest, or it may feel like it is beating once and then stopping.
- Body swelling (Edema): Swelling in the ankles, legs, or abdomen.
- Weakness or dizziness: You may feel dizzy, as if you suddenly stood up.
- Sudden increase in body weight.
- Chest pain: You may experience a tightening sensation in your chest, especially when doing strenuous work.
Why do these types of valve diseases occur? What are the causes?
There are several reasons why heart valves can become damaged. Some are things we can control, and some are not.
- Rheumatic fever: A condition that occurs when a throat infection (strep throat) is left untreated in childhood. This can damage the heart valves. This is a common cause in our country.
- Heart attack: Damage to the heart muscle caused by a heart attack can also affect the function of the valves.
- High blood pressure: High blood pressure that is not controlled for a long time can damage the heart.
- Congenital issues: Some people are born with a valve defect.
- Valve weakening with age: As we age, calcium deposits (calcification) in the tissues of the valves can thicken and weaken them.
- Infective endocarditis: A bacterial infection from elsewhere in the body that travels through the bloodstream and damages the heart valves.
- Other medical conditions: Some diseases, such as lupus and Marfan syndrome, can also damage the valves.
Factors that increase risk
- Tobacco use.
- Unhealthy diet.
- Not exercising.
- Having diseases such as diabetes and high blood pressure.
- Having received radiation treatment for cancer.
- Aging.
How does a doctor diagnose valve disease?
When you go to see a doctor, he or she will examine you. When listening to your chest with a stethoscope, if you hear an unusual sound in addition to the normal heart sounds, a "heart murmur," it could be a sign of a valve problem. They will also look for fluid in the lungs and swelling in the legs.
After that, it is recommended to undergo several tests to confirm the disease and determine its severity.
| Name of the test | What is simply happening? |
|---|---|
| Echocardiogram | This is an ultrasound scan of the heart. Just like scanning a pregnant mother's belly, a device is placed on the surface of the chest and the heart beats, the valves open and close, and the blood flows like a video. |
| Trans-esophageal Echo (TEE) | This is the same as an echo scan, but a small tube with a scanning device is inserted through the esophagus and placed very close to the heart. This can produce very clear images of the heart valves. |
| Electrocardiogram (ECG/EKG) | A test that records the electrical activity of the heart. This is done by placing small stickers on the chest and limbs. |
| Chest X-ray | A chest X-ray can show whether the heart is enlarged or the lungs are filled with fluid. |
| Cardiac Catheterization | A very thin tube is passed through a vein in the arm or leg to the heart, a special substance is injected, and the function of the coronary arteries and valves of the heart is examined using X-ray video. This is also called an angiogram. |
What are the treatments?
Treatment depends on the type of valve disease you have, its severity, your age, and your overall health.
1. Medications
Medications cannot reverse valve damage. However, they can help control symptoms, reduce the strain on the heart, and prevent complications such as blood clots. Your doctor will prescribe medications to control things like high blood pressure, cholesterol, and irregular heartbeats (arrhythmias).
2. Surgery
If symptoms are severe or if the heart is being damaged, surgery may be necessary. There are two main methods.
- Valve Repair:Whenever possible, doctors' first choice is to repair and rebuild your own valve because it reduces the risk of infection, eliminates the need for lifelong blood-thinning medications, and preserves the heart's function.
- Valve Replacement: If the valve is damaged beyond repair, it is removed and a new valve is implanted. There are two types of these new valves:
- Mechanical Valves: These are permanent, but once they are inserted, you will need to take blood thinners for the rest of your life.
- Biological/Tissue Valves: These are made from animal (pig or cow) heart tissue. They do not require long-term blood thinners, but they can deteriorate after 10-15 years, requiring repeat surgery.
Nowadays, this surgery can be performed through a small incision (minimally invasive surgery) without completely removing the breast. Your doctor will explain to you which method is best for you.
Things to consider when living with valve disease
Having valve disease means you need to take a little more care of your health.
- See your doctor regularly: Even if you don't have any symptoms, go for checkups as scheduled by your doctor. It's important to monitor the condition of the valve for any changes.
- Protect yourself from infections: Your biggest risk is a heart infection called infective endocarditis . Prevent this by:
- Take great care of your teeth and gum health. Brush your teeth thoroughly every day.
- Tell your dentist and any other doctor that you have heart valve disease.
- Ask your cardiologist if you need to take antibiotics before a tooth extraction or other minor surgery.
- A healthy lifestyle: Avoid smoking, eat a balanced diet, and exercise as directed by your doctor.
When should I see a doctor as soon as possible?
If your symptoms (fever, chest pain, leg swelling) worsen or occur frequently, see your doctor immediately.
When should you go to the Emergency Treatment Unit (ETU)?
If these symptoms occur, especially after valve surgery, go to the ETU (Emergency Treatment Unit) immediately or call 1990.
- Sudden loss of consciousness.
- Severe chest pain.
- Severe shortness of breath that does not subside even with rest.
- Heart rate increases above 150 beats per minute.
- Fever or chills.
- Coughing up blood.
Take-Home Message
- Don't ignore symptoms like fatigue, unusual tiredness, and chest pain as normal. They could be a sign of valvular disease.
- Heart valve disease is a condition that can be treated very successfully these days. There is no need to be afraid.
- Go for regular check-ups and tests as prescribed by your doctor. That's the best way to protect your heart.
- Small lifestyle changes (good diet, exercise, quitting smoking) can make a big difference to your heart health.
- If you have valvular disease, tell all your doctors, including your dentist, about it. It's very important to prevent infections.
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