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Valvular Heart Disease

What is valvular heart disease?

Valvular heart disease is any dysfunction or abnormality of one or more of the heart's four valves.

The four valves of the heart are:

The Tricuspid Valve

The tricuspid valve is a flap that lies between the right atrium and the right ventricle. When it opens it allows the impure (de-oxygenated) blood collected in the right atrium to flow into the right ventricle. When the right ventricle contracts it closes and prevents blood from flowing back into the right atrium.

Pulmonary Valve

The de-oxygenated blood sent out of the right atrium flows into the right ventricle. When the ventricle contracts, the pulmonary valve opens and lets the blood flow out of the heart into the pulmonary artery. The pulmonary artery takes it to the lungs for purification (oxygenation). The Pulmonary valve closes as the ventricles relax, preventing de oxygenated blood from returning to the heart.

Mitral Valve

The mitral valve is a flap that lies between the left atrium and the left ventricle. The pulmonary vein brings oxygenated blood from the lungs to the left atrium. The mitral valve opens to allow this blood to flowing into the left ventricle. It closes as the left ventricle contracts, preventing blood from flow back into the left atrium; thereby, forcing it to exit through the aortic valve into the aorta.

Aortic Valve

Pure blood flowing into the left ventricle leaves the heart through the aorta. The aortic valve separates the left ventricle from the aorta. As the ventricles contract, it opens to allow the oxygenated blood collected in the left ventricle to flow throughout the body. It closes when the ventricles relax, preventing blood from returning to the heart.

Valvular heart diseases can be of different types. Some of the commonly occurring conditions are:

  • Valvular Stenosis: A valve becomes stiff or thick, gets fused or blocked. This prevents the smooth flow of blood through the valve.
  • Valvular Regurgitation: A valve does not close properly letting blood flow in the wrong direction. ( Mitral valve prolapse , for instance may lead to regurgitation)
  • Valvular Atresia: A valve is not developed properly or is closed since birth.

The Aortic and Mitral valves are more commonly affected and the implications are serious when these are affected.

What causes valve problems?

  • Rheumatic Fever. This used to be one of the main causes of valve damage in the past. But today with the use of antibiotics and the early detection and control of Rheumatic Fever and Heart Disease, valvular problems resulting from this condition occur less frequently.
  • Congenital defects. Some people are born with malformed or malfunctioning valves.
  • Other heart diseases such as Coronary Heart Disease, a Heart Attack or Infective Heart Diseases can damage heart valves.
  • Degenerative causes. The adult heart pumps 7,500 litres of blood each day. Though it is one tough muscle, it can wear out. Myxomatous degeneration and Calcific degeneration are types of degenerative problems which cause the heart valves to thicken.
  • Certain types of medication.

What are the symptoms of valve diseases?

When a valve narrows or leaks, blood flow is restricted. This puts strain on the heart and can lead to heart failure and irregular heart rhythms.

Some patients of valve disease do not feel any symptoms. Others exhibit one or more of the following symptoms.

  • Chest pain.
  • Fatigue.
  • Breathlessness after exertion.
  • Cough.
  • Heart palpitations.



You may be put on anti coagulant medication. Anticoagulant Medication lengthens the amount of time it takes for blood clots to form. It lowers the chance of blood clots forming around the diseased heart valves.

How long you take an anticoagulant depends on the type of valve disease you have or surgery you have had for a valve disease.

If, after surgery, you have been provided a mechanical valve, you will need to take an anticoagulant for the rest of your life. Since blood clots are less likely to form around biological valves, an anticoagulant may not be permanently needed for a biological valve implant.

Precautions necessary when using Anticoagulants:

  • Anticoagulants increase the risk of bleeding, so you will need to have your blood coagulation profile checked regularly when taking an anticoagulant.
  • If you injure yourself, you will bleed easily. Try to stop bleeding by applying pressure on the wound. Get medical help if it does not stop.
  • Take the medication exactly as it has been prescribed.
  • Check with your doctor or pharmacist before taking any non prescription medication. Some over the counter medications can interfere with the action of certain anticoagulants. Do not take aspirin or medication containing aspirin, without consulting your doctor.
  • Report any of the following signs of bleeding to your doctor right away:
    • Nose bleeds
    • Excessive bruising
    • Excessive bleeding
    • Bleeding gums
    • Black stools
    • Severe and frequent headaches


Heart Valve Surgery

If possible, your own heart valve will be repaired. If your valve cannot be repaired, it will be replaced either with a biological valve (a valve made of tissue) or a mechanical valve (a valve made of mechanical parts). The type of valve that is used depends on your body type, your medical history, the extent of your valve disease, your age and your life-style.

Valvular surgery is most often an open heart surgery. Valve repair or replacement is one of the less risky heart surgeries. The operation takes approximately three to six hours depending on its complexity. General anaesthesia is administered to the patient.

Minimally invasive procedures, using smaller incisions, or using catheters in case of stenosis are also performed. For stenotic valve disease, a catheter is placed in the femoral artery in the groin and is passed up through the aorta. A special balloon attached to the catheter is then expanded to correct such lesions as aortic stenosis and mitral stenosis in certain select patients.

Biological Valves

Biological valves may be made from either animal or human tissue. For children who are still growing and women who are considering pregnancy, a biological valve is often used due to the changing size of the heart. After surgery, a person receiving a biological valve may be placed on an anticoagulant medication for a short time to prevent blood clots from forming or dislodging around the new valve.

Since a biological valve is made of tissue and will age as other body parts do, it may need to be replaced in about eight to 10 years. How long your valve lasts depends among other things on which one of your heart valves is replaced.

Mechanical Valves

Mechanical valves are usually made of metal, plastic or dacron. They generally last longer then biological valves. If a mechanical valve is used to replace your own heart valve, you may need to take anticoagulant medication for the rest of your life. A mechanical valve may need to be replaced if other heart problems affect the valve.

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