Valvular heart disease

What is valvular heart disease?

Valvular heart disease encompasses a number of conditions that affect the function of the heart valves, serving to enable efficient blood flow.  The heart is composed of four valves: the mitral, aortic, tricuspid and pulmonary valves.

Currently in the UK, the most common forms of valvular heart disease are Aortic Stenosis and Mitral Regurgitation.  Aortic stenosis, or narrowing of the aortic valve, is normally caused by a build-up of calcium on the valve.  This is represented by the dense, white structure circled in the image below, taken with echocardiography. This prevents the valve leaflets from opening effectively and causes a reduction of blood flow to other organs including the brain. 

What are the symptoms of valvular heart disease?

As a result a patient can develop black-outs, chest pain and breathlessness.  Mitral regurgitation arises when the leaflets comprising the mitral valve fail to close properly, causing a leak of blood in the wrong direction.  Most commonly this condition when severe can cause the patient to become breathless.

What are the causes of valvular heart disease?

Both of these valve diseases are commonly found with advancing age. Aortic stenosis in younger individuals can arise from a birth defect known as a bicuspid aortic valve, or a valve composed of two leaflets instead of three. Mitral regurgitation can also occur in the setting of a myocardial infarction, as a consequence of cardiac failure and can also develop from infective endocarditis, or growth of bacteria on the valve.

How is valvular heart disease treated?

If left untreated these conditions can lead to cardiac failure. The most common management strategy involves a valve replacement, although increasingly commonly a more novel technique called Transcatheter Aortic Valve Implantation or TAVI is an option for aortic stenosis, usually in individuals who are thought to be high risk for conventional surgery.