Understanding valvular heart disease

      Cardiovascular disease comes in many forms: High blood pressure, coronary heart disease and stroke are probably the three types you hear about most often. Another form is valvular disease, which affects the valves that control blood flow into and out of your heart.
      Valvular disease occurs when a valve no longer fully opens or closes, doing an inadequate job of allowing blood to flow freely through your arteries or keeping it away from places it doesn’t belong. Some people are born with a valve defect and may not know it until complications occur later in life. Your valves can also become damaged when calcium deposits build up as you age. A heart attack or a case of rheumatic fever, too, can damage a valve.
      The disease can remain symptomless until it becomes severe. As it progresses, you may experience symptoms like fatigue, shortness of breath, chest pain and dizziness. Sometimes your doctor may detect a heart murmur—a sign of a damaged valve—when he or she listens to your heartbeat through a stethoscope. If left undetected, some forms of valvular disease can result in heart failure.
      The severity and treatment of valvular disease depend on the type. The most common types include the following:
• Mitral valve prolapse occurs when you have a leaky valve that lets blood flow back into your heart. Most patients with the disorder never need medical attention other than occasional monitoring. However, if too much blood flows back into your heart, you may have mitral valve regurgitation, which can require surgery.
• Aortic valve regurgitation, like mitral valve regurgitation, occurs when blood flows back into your heart through a leaky valve, in this case the aortic valve, which releases blood from your heart to your body’s main blood vessel, the aorta. The same treatment applies: Surgery to repair the problem.
• Mitral valve stenosis occurs when a valve becomes narrow and obstructs blood flow. If the condition becomes severe, you’ll need surgery to repair or replace the valve. Mild cases can be treated with medications to control symptoms like an irregular heartbeat.
• Aortic valve stenosis occurs when the aortic valve narrows, preventing blood from easily leaving your heart to circulate. This forces your heart to pump harder and eventually weakens it. Medication will control your symptoms. If the stenosis becomes severe, surgery will be necessary.
• Endocarditis is an infection in your heart’s inner lining. People who already have a valve disorder are at high risk for developing endocarditis, which can severely damage the valves. This infection occurs when bacteria elsewhere in your body travels to your heart. Endocarditis is fatal if left untreated. Fortunately, it’s rare in people with otherwise healthy hearts and whose immune systems will destroy the bacteria. However, it can be spread by sharing or using contaminated needles or syringes. Treatment requires immediate hospitalization and intravenous antibiotics.
      Just as with other types of cardiovascular disease, people who smoke or are overweight are more likely to develop valvular disease than fit nonsmokers. Other risk factors include high blood pressure, high cholesterol and high blood sugar.

Keeping the flow in check
       Here are some precautions you can take to help prevent valvular disease or reduce its complications if you already have a defective heart valve:
• Keep your cholesterol under control to prevent calcium from building up in your valves.
• Follow a healthy lifestyle—stay active, eat right, avoid stress and get plenty of sleep—since a heart attack can cause valvular disorders.
• If you develop strep throat, see a doctor for treatment. Strep throat can develop into rheumatic fever, which can damage your valves.
• Let all your healthcare providers, including your dentist, know that you suffer from a valve disorder. Since invading bacteria can cause a seemingly harmless case of valvular disease to develop into endocarditis, check with your cardiologist about whether you may need to take antibiotics before any dental or medical treatment to ward off infection.
• See your doctor if you feel fatigued, short of breath, dizzy or faint to prevent existing valvular disease from worsening.