What is it

Valvular heart disease is a disorder or disease of the heart valves, which are the tissue flaps that regulate the flow of blood into and out of the chambers of the heart.

Patients with valvular heart disease have a malfunction of one or more of the heart valves. There are several types of valvular heart diseases with distinct symptoms and treatment options.

Problems with heart valves may occur as a result of infections (most commonly infective endocarditis and rheumatic fever), degeneration, or congenital abnormality.

Causes and Symptoms

Infective endocarditis – Most people with a healthy, normal heart are not at significant risk for contracting this infection of the heart valve. Those who have had rheumatic fever, with resulting scarring, or congenital heart disease, may contract this disease.

Dental surgery or any surgery involving the mouth, bladder, prostate, or female pelvic organs increases the risk for this infection. The disease also may occur in drug addicts who inject drugs into their veins using unsterilised needles, even if they have normal heart valves.

Patients who have developed the disease may report fever, fatigue, night sweats, chills, and joint inflammation.

In patients where the disease has developed more slowly, symptoms may include signs of rapid heart rate, an enlarged spleen, various skin rashes or spots, and heart murmur.

Rheumatic fever – This results from an allergic response to certain types of streptococcal bacteria. If it occurs, it is most often in children who have had streptococcal infections that were not completely treated.

Chronic rheumatic heart disease can result from just one occurrence or repeated attacks of rheumatic fever.

The symptoms of rheumatic fever include fever, joint pains, and either lumps under the skin or raised red patches on the skin.

Other valvular heart disease – With ageing, deposits of calcium can lead to thickening and leakage of heart valves. Heart attacks can also damage the mitral valve structures, and certain connective tissue disorders such as Marfan’s syndrome and myxomatous degeneration, can also adversely affect the heart valves.

Diagnosis

Specific types of valvular heart disease are diagnosed using electrocardiogram, echocardiogram, certain x-ray studies, and / or cardiac catheterisation.

Infective endocarditis
A diagnosis can be obtained through history, physical examination, lab tests, ECG and echocardiogram.

Rheumatic fever
Rheumatic fever may be suspected following a recent throat infection. Symptoms include joint ache, abnormal electrocardiogram or heart inflammation as indicated in a blood test. Heart murmurs may be detected from routine examination.

Treatment

The treatment of specific valvular heart disease will vary, depending on the valve involved and the extent of damage or malfunction. Some patients will not require any specific treatment and many can be treated with medications. Sometimes, patients need surgery. If multi-valvular disease is suspected, the different valves may be evaluated during surgery on one of the affected valves. Women with heart valve disease and want to become pregnant should receive a thorough check-up and see a cardiologist regularly throughout their pregnancy.

Infective endocarditis
Depending on the type of bacterium that caused the disease, an appropriate antibiotic or combination of antibiotics will be used to treat infective endocarditis. Severe cases may be corrected by valve replacement surgery.

Rheumatic fever
Patients with rheumatic fever will be treated with antibiotics to eliminate streptococcal organisms that may still remain in the heart. Patients may receive antibiotics to prevent further infection, and inflammation may be treated with aspirin or cortisone-like drugs.