Heart valve disease is any disturbance that occurs invalve heart.This condition can be characterized by noisy or abnormal heart sounds, chest pain, dizziness, and shortness of breath.
The heart valve or heart valve is an organ in the heart that has a function like a one-way door. The heart valves are responsible for maintaining the flow of blood originating from the heart to flow properly, either between the chambers of the heart or from the heart out to the blood vessels.
Basically, the heart has four valves, namely:
- The tricuspid valve, which carries blood from the right atrium to the right ventricle
- The mitral valve, which carries blood from the left atrium to the left ventricle
- The pulmonary valve, which carries blood from the right ventricle to the blood vessels leading to the lungs (pulmonary arteries)
- The aortic valve, which carries blood from the left ventricle to the blood vessels leading to the rest of the body (aorta)
If there is one or more heart valves that are impaired, it will affect the heart's process of circulating blood, including oxygen, throughout the body.
Types of Heart Valve Disease
Heart valve disease is divided into three types, namely:
Heart valve stenosis
Heart valve stenosis occurs when the heart valves become stiff, thickened, or stick together, so they can't open properly. This condition prevents blood from flowing into the heart chambers or blood vessels. As a result, the heart muscle has to work harder to pump blood.
Heart valve insufficiency or regurgitation
In this condition, also known as a leaky heart valve, the heart valve cannot close properly. This causes blood to flow back into the heart chambers, so the amount of blood flowing throughout the body is reduced.
Heart valve deformity
In this condition, the heart valves may not form (atresia) or form improperly. Usually, this disorder occurs from birth. Depending on the shape of the heart valves, this condition can cause severe disruption of blood flow, but it can also cause no disturbance.
Each type of heart valve disease can occur in all four heart valves. Even in some cases, the two types of heart valve disease above can occur simultaneously in one or more valves.
Causes of Heart Valve Disease
Heart valve disease can be present at birth or develop as an adult due to certain health conditions. Here is the explanation:
Congenital heart valve disease
This type of heart valve disease occurs due to a disturbance in the process of forming the heart in the uterus. This disorder can occur alone or in conjunction with congenital heart disease. Generally, the cause of congenital heart valve disease is difficult to determine.
Congenital disorders that cause connective tissue disorders, such as Marfan syndrome, can also cause heart valve abnormalities from birth. However, this does not necessarily occur in all people with Marfan syndrome.
Acquired heart valve disease
This heart valve disease occurs due to other conditions or diseases suffered, such as:
- Rheumatic fever
- High blood pressure
- Atherosclerosis
- Heart failure
- Cardiomyopathy
- Tissue damage from a heart attack
- Endocarditis
- Autoimmune disease
- Metabolic disorders
In addition, there are also several factors that can trigger heart valve disease, namely:
- aging process
- Obesity
- Unhealthy lifestyle, such as smoking and lack of exercise
- History of taking certain medications, such as weight loss drugs
- Radiotherapy
Symptoms of Heart Valve Disease
Heart valves play a role in maintaining the smooth flow of blood in and out of the heart. The heart valves work every time the heart beats. The "loop-dup" sound of the heart comes from the sound of valves closing after delivering blood.
The mitral and tricuspid valves open as blood flows into the ventricles of the heart. When these two valves close and prevent blood from flowing back into the atria, a "loud" sound occurs.
Blood that is already in the chambers will be pumped out through the pulmonary valve and the aortic valve. After all the blood enters the pulmonary arteries and aorta, these two valves will immediately close and make a "dump" sound.
When there is interference with the heart valves, the above heart sounds will also experience abnormalities. That is why the main symptom of valvular heart disease is a heart murmur, or noise in the heart. However, these symptoms often cannot be felt by the sufferer and can only be known through a doctor's examination.
However, there are also additional symptoms that sufferers can feel. These symptoms arise due to ineffective blood flow which causes the heart to work harder. These symptoms are:
- Chest pain
- Heart palpitations, beats irregularly, or feels “vibrating”
- Dizzy
- Faint
- Cheek flushing, especially in patients with mitral valve stenosis
- Hard to breathe
- Fatigue
- Edema (excessive swelling in the legs, abdomen, or ankles as a result of fluid blockage) which also causes rapid weight gain
- Coughing up blood
Symptoms of heart valve disease can vary for each patient, depending on the type of heart valve disorder experienced and its severity. Symptoms can appear slowly or can also suddenly and develop very quickly.
When to go to the doctor
Immediately consult a doctor if you experience the above symptoms to get the appropriate examination and treatment. The sooner it is treated, the greater the need for heart valve disease to improve.
Heart Valve Disease Diagnosis
The diagnosis of heart valve disease begins with a question and answer session about the patient's symptoms, medical history, and lifestyle, which is then followed by a physical examination.
A physical examination is performed using a stethoscope to detect abnormal heartbeat sounds (noise or heart murmur) or irregular heart rhythms.
After a physical examination, the doctor may run additional tests to confirm the diagnosis. The most common investigation is echocardiography. This examination is used by doctors to see the movement of the heart, the size of the heart valves and chambers, and the flow of blood through the heart valves.
There are also several other supporting tests that doctors can do to diagnose heart valve disease, namely:
- Electrocardiography (ECG), to determine the electrical activity of the heart, detect enlargement of the heart chambers, and heart rhythm disturbances
- X-ray of the chest, to see if a disturbance in the heart valves has affected the lungs or caused an enlarged heart
- Treadmill ECG, to see if the symptoms of heart valve disease worsen when the patient does physical activity (eg walking treadmill)
- Cardiac catheterization, to see the coronary blood vessels in detail and measure the pressure of the heart cavity
- Cardiac MRI, to see a detailed picture of the heart and its valves, and to determine the severity of heart valve disease
Heart Valve Disease Treatment
Treatment of heart valve disease is adjusted to the severity of the condition. Usually, doctors will start treatment by advising patients to adopt a healthy lifestyle, such as not smoking, eating foods that are good for the heart, and getting enough rest.
After that, the doctor will carry out more special treatment, such as:
Drug administration
There are no drugs that can completely treat valvular heart disease. However, doctors can prescribe medications that can relieve symptoms and slow the progression of the disease. These drugs are:
- Diuretics, which function to remove fluid from the bloodstream and body tissues, so that the burden on the heart can be reduced
- Beta blockers, such as bisoprolol, which works to lower blood pressure and ease the work of the heart by making the heart beat more slowly
- Antiarrhythmics, such as amiodarone, which work to control heart rhythm disturbances
- ACE inhibitors, such as ramipril, which serves to reduce the workload of the heart
- Vasodilators, such as nitroglycerin, which serves to ease the work of the heart and keep blood flow from turning back
If the patient's cholesterol level is very high, the doctor may also prescribe medication to lower it and advise the patient to adopt a healthy diet. This is important to prevent the occurrence of other heart diseases, such as coronary heart disease, which will worsen the symptoms of heart valve disease.
Operation
Surgery can be performed to repair or replace the damaged heart valve. The severity of the disease, age, and general health conditions are things that doctors consider when recommending surgery.
Heart valve repair surgery is recommended over heart valve replacement surgery. This is because heart valve repair surgery has a lower risk of causing complications of endocarditis.
Patients who undergo heart valve repair surgery do not need to take blood thinners for life, such as heart valve replacement surgery.
However, heart valve repair surgery is more difficult to perform than heart valve replacement surgery. Moreover, not all heart valves can be repaired, for example the mitral valve is easier to repair, while the aortic and pulmonary valves generally require replacement.
Complications of Heart Valve Disease
Without proper treatment, heart valve disease can lead to complications, such as:
- Heart failure
- stroke
- Atrial fibrillation
- Heart muscle damage
- Pulmonary hypertension
- Blood clotting
- Endocarditis
Heart Valve Disease Prevention
One way that can be done to prevent heart valve disease is to prevent the occurrence of diseases that can damage the heart valves. For example, rheumatic fever can be prevented by treating a streptococcal infection as soon as possible.
In addition, immediately see a cardiologist if you experience symptoms of a condition or disease that can cause heart valve disorders, such as shortness of breath due to cardiomyopathy, so that treatment can be given immediately so that the risk of developing heart valve disease can be reduced.
Implementing a healthy lifestyle, such as exercising regularly, getting enough rest, avoiding smoking, and eating a diet that is good for heart health, can also reduce the risk of heart valve disease.