Heart valve disease
The heart valves act as one-way valves, allowing blood to flow through the heart in the right direction. For the heart to work efficiently, the valves must open and close fully at precisely the right moment in every heartbeat. When a valve does not open wide enough or does not close completely, blood flow becomes obstructed or inefficient; this is called heart valve disease.
The valves can be affected by two basic types of disorder. The first is stenosis, in which the valve opening is narrowed, so the heart has to work harder to pump the blood out. The second is regurgitation (insufficiency), in which the valve does not close properly and blood flows backwards, putting a strain on the heart chambers. Valve disease can be congenital, but it most often develops with age, particularly because of degenerative age-related changes. Causes can also include long-standing high blood pressure, infections of the heart structures (endocarditis), rheumatic fever, the effects of dilatation of the heart chambers, or a previous heart attack.
The most common valve diseases include aortic stenosis, which can cause symptoms such as shortness of breath, chest pain and fainting. Mitral regurgitation is also very common: some of the blood flows back from the left ventricle into the left atrium, which can lead to shortness of breath, fatigue and, over time, enlargement of the heart chambers.
The symptoms of valve disease often develop slowly, and many patients have no symptoms at all for a long time. When symptoms appear, they most often include shortness of breath, reduced stamina, tiring more quickly, palpitations, swollen legs or chest pain. In the early stage the disease is often discovered by chance, for example when the doctor hears a heart murmur through the stethoscope, which is often the first sign of a change in the valves. The diagnosis is usually made with a heart ultrasound, which clearly shows the structure and function of the valves and assesses how severe the damage is.
Treatment depends on the type and degree of damage. In milder forms, regular monitoring and control of risk factors are sufficient. When the disease progresses or causes marked symptoms, surgical repair or replacement of the valve may be considered. In some cases, especially in older or high-risk patients, a modern minimally invasive procedure such as TAVI (transcatheter aortic valve implantation) can be used for aortic stenosis. Timely diagnosis and treatment can significantly improve quality of life and prevent the development of heart failure.
Valve diseases often progress slowly, so regular cardiology examinations and follow-up ultrasound scans are the best way to detect them early and monitor them.
