Valvular Disease
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Simply put, valvular disease is when valves in the heart are not working correctly. This often occurs when the valves stiffen resulting in the valves narrowing upon opening (stenosis), or when the valves do not close correctly which can lead to blood leakage and backflow (regurgitation or insufficiency). Symptoms may include palpitations, shortness of breath, weakness, dizziness, rapid weight gain from water retention and swelling, and chest pain or pressure, especially upon exertion.
Each of the heart’s four chambers has a valve that opens and closes to maintain blood flow in one direction. Blood enters the right atrium, passes into the right ventricle through the tricuspid valve, and then flows into the lungs through the pulmonary valve. Upon entering the left atrium from the lungs, blood flows through the mitral valve into the left ventricle and exits into the body through the aortic valve. When the valves are working correctly, the tricuspid and mitral valves are closed to prevent blood backflow when the ventricles are filled with blood. Upon contraction, the pulmonary and aortic valves open to let out the blood and then close again.
Valvular disease can be congenital (from birth) or acquired during life, most commonly from other heart diseases, infection, with age and from lifestyle influences that can raise blood pressure. Congenital defects include valves that are malformed or the wrong size, usually affecting the pulmonary, mitral and aortic valves. In such cases, valve leaflets (flaps) may not be able to close correctly, causing blood to backflow and thus reducing pumping efficiency.
Rarely, acquired valvular disease can result from rheumatic fever (a rare complication associated with strep throat) or a bacterial infection of the valve (endocarditis). However the most common cause of valve disease in adults is simply degeneration of the leaflets. Over time, valve leaflets can become thickened, floppy or calcified. Valves that slowly become thicker and more calcified do not open normally. This condition is called stenosis and most often affects the aortic valve. Leaflets that become thickened and floppy do not close normally and allow blood to flow backward. This condition is call regurgitation and can affect any valve, but more commonly the mitral valve.
A relatively common condition is mitral valve prolapse (MVP), where the mitral valve leaflets do not close properly and may bulge backward into the atrium, resulting in leakage. Most patients with this condition, however, are only mildly affected, show no symptoms and don’t need treatment. Still other acquired causes of valvular disease include enlarged heart muscle (cardiomyopathy), coronary disease from blockages, high blood pressure, aortic aneurysms and rarely heart tumors.
MDCA cardiologists are experts in diagnosing and treating valvular diseases using the latest breakthroughs in procedures and technology. Our physicians have co-authored the current national guidelines for imaging evaluation of valvular dysfunction and for updating national guidelines for prosthetic valve evaluation. Physicians and staff work as a collaborative team to analyze and assess complex valvular disorders and treatments. In addition, our newly-opened specialty Heart Valve Clinic offers renewed evaluation, second opinion consultation, diagnosis and treatment options for patients with complex valvular conditions.
SERVICES
- Diagnosis and treatment
- Imaging evaluation
- Heart Valve Clinic – second opinions regarding treatment options including surgery, minimally invasive procedures and medical therapy
- Interventional, catheter-based therapies
Physicians
- Stephen H. Little, M.D., FRCPC, FACC, FASE
- Miguel A. Quiñones, M.D., FACC
- William A. Zoghbi, M.D., FACC, FAHA, FASE
