What causes valvular heart disease?
There are several causes of valvular heart disease, including congenital conditions (being born with it), infections, degenerative conditions (wearing out with age), and conditions linked to other types of heart disease.
- Rheumatic disease can happen after an infection from the bacteria that causes strep throat is not treated with antibiotics. The infection can cause scarring of the heart valve. This is the most common cause of valve disease worldwide, but it is much less common in the United States, where most strep infections are treated early with antibiotics. It is, however, more common in the United States among people born before 1943.
- Endocarditis is an infection of the inner lining of the heart caused by a severe infection in the blood. The infection can settle on the heart valves and damage the leaflets. Intravenous drug use can also lead to endocarditis and cause heart valve disease.
- Congenital heart valve disease is malformations of the heart valves, such as missing one of its leaflets. The most commonly affected valve with a congenital defect is a bicuspid aortic valve, which has only two leaflets rather than three.
- Other types of heart disease:
- Heart failure. Heart failure happens when the heart cannot pump enough blood and oxygen to support other organs in your body.
- Atherosclerosis of the aorta where it attaches to the heart. Atherosclerosis refers to a buildup of plaque on the inside of the blood vessel. Plaque is made up of fat, calcium, and cholesterol.
- Thoracic aortic aneurysm, a bulge or ballooning where the aorta attaches to the heart.
- High blood pressure.
- A heart attack (also known as myocardial infarction or MI), which can damage the muscles that control the opening and closing of the valve.
- Autoimmune disease, such as lupus.
- Marfan syndrome, a disease of connective tissue that can affect heart valves.
- Exposure to high-dose radiation, which may lead to calcium deposits on the valve.
- The aging process, which can cause calcium deposits to develop on the heart valves, making them stiff or thickened and less efficient with age.
What are the symptoms of valvular heart disease?
Heart valve disease can develop quickly or over a long period. When valve disease develops more slowly, there may be no symptoms until the condition is quite advanced. When it develops more suddenly, people may experience the following symptoms:
- Shortness of breath
- Chest pain
- Dizziness or fainting
- Rapid weight gain
- Irregular heartbeat
How is valvular heart disease diagnosed?
The doctor may hear a heart murmur (an unusual sound) when listening to your heartbeat. Depending on the location of the murmur, how it sounds, and its rhythm, the doctor may be able to determine which valve is affected and what type of problem it is (regurgitation or stenosis).
A doctor may also use an echocardiography, a test that uses sound waves to create a movie of the valves to see if they are working correctly.
How is valvular heart disease treated?
If the condition isn’t too severe, it might be managed with medicines to treat the symptoms. If the valve is more seriously diseased and causing more severe symptoms, surgery may be recommended. The type of surgery will depend on the valve involved and the cause of the disease. For some conditions, the valve will need to be replaced by either opening the heart during surgery or replacing the valve without having to open the heart during surgery.
- Otto CM, Bonow RO. Valvular Heart Disease: A Companion to Braunwald’s Heart Disease. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014.
- Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2017 on CDC WONDER Online Database, released December, 2018. Data are from the Multiple Cause of Death Files, 1999-2017, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Oct 24, 2019.