What Every Patient Should Know About Heart Valve Disorders
Types of Heart Valves
There are two main types of valves that affect the heart: mitral and aortic.
- Mitral valve: Allows blood to flow from the left atrium to the left ventricle of the heart
- Aortic valve: Allows blood to flow from the left ventricle to the aorta, and out to the body
Some people experience issues with the tricuspid valve (the valve that allows blood to flow from the right atrium to the right ventricle) and pulmonary valve (which allows blood to flow from the right ventricle to the lungs, where it receives oxygen), but these are less common in adults.
Heart Valve Disorders
The main valve conditions that disrupt the flow of blood in your heart are:
- Stenosis: The stiffening or thickening of the valve. Stenosis keeps the valve from opening all the way and limits blood flow.
- Regurgitation: A leaky valve that doesn’t close completely. As a result, blood goes back into a chamber instead of forward.
A third type of heart valve disorder, atresia, is when the valve is closed or doesn’t exist. It’s normally diagnosed within a few days or birth and requires immediate treatment.
Valve disorders can affect any of the four valves, and are named based on the valve that causes the problem. The most common valve disorders include:
- Mitral stenosis: Blood flow from the left atrium to the left ventricle is restricted. This causes the left atrium to work harder to send adequate blood to the left ventricle, resulting in congestion in the lung vessels. Since the right ventricle is responsible for filling the left side of the heart, this restriction and congestion may eventually cause the right ventricle to fail.
- Mitral regurgitation: Also known as mitral insufficiency, the mitral valve allows blood to flow back into the left atrium from the left ventricle. This causes pressure in the left atrium, eventually causing lung vessel congestion.
- Mitral valve prolapse: The most common heart valve abnormality and the No. 1 cause for mitral regurgitation, this is when the mitral valve doesn’t open and close properly.
- Aortic stenosis: Restricts blood flow from the left ventricle to the aorta, resulting in increased pressure in the left ventricle to compensate for this restriction so that enough blood flows to the rest of the body. This pressure overload causes the left ventricle to increase thickness in the walls (hypertrophy).
- Aortic regurgitation: Also known as aortic valve insufficiency, the aortic valve does not close properly, allowing blood to leak back from the aorta into the ventricle. This causes increased pressure in the left ventricle, resulting in lung congestion.
Risk Factors and Symptoms
As you get older, your risk of a getting a heart valve disorder increases. You may also be at higher risk if you’ve had a heart attack or heart failure, or are at risk for coronary artery disease.
Some people with a heart valve disorder experience no symptoms. Those who do may have:
- Heart murmur: An unusual heartbeat
- Chest pain
- Shortness of breath
- Fatigue
- Swelling in ankles, feet, or legs
- Diagnosis
If your doctor hears a heart murmur by listening to your heart with a stethoscope, this may indicate a valve problem. The next step is a referral to a cardiologist for further examination and additional testing, which may include:
- Chest X-ray: Will indicate if you have a heart problem.
- EKG: A five-minute test that detects the rate and rhythm of the heartbeat; this will show us if you have an abnormal heart rhythm often associated with a valve problem.
- Echocardiogram (ECHO): Uses an ultrasound to visualize the heart and will show in some detail if there is a heart valve problem and what type of problem it is.
- Stress test: Determines the health of your heart, including pumping efficiency. There are several different types of stress tests that we may recommend, including an exercise stress test.
- Cardiac catheterization: A catheter inside the heart assesses the health of the heart and any damage.
- Cardiac MRI: A magnetic resonance image (MRI) may reveal additional information that isn’t revealed in the ECHO. The MRI creates both a still and moving picture of your heart, which we use to find problems with structure and function.
Treatments
Heart valve disorders are treated either surgically or percutaneously (a needle puncture through the skin). The goal is to repair or replace the valve, and this can be done in one of three ways: open surgery, minimally invasive surgery, or percutaneously. At UT Southwestern, we are experts in whichever treatment is appropriate for each patient, and we offer several innovative surgical options patients won’t find anywhere else in North Texas.