Advances in Aortic Stenosis

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Could You Have Heart Valve Disease?

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Your heart has four valves—the aortic, mitral, pulmonary, and tricuspid valves. These valves have small flaps that open and close every time your heart beats. They help move blood through your body and keep it flowing in the right direction.

Sometimes, though, heart valves fail to work properly. Some people are born with defective valves; others develop complications over time, as a result of things like age or infection. The heart valve opening may be too narrow, allowing less blood to flow through. One common, yet serious, example of this is aortic stenosis, where the narrowed aortic valve opening restricts blood flow through the aorta to the rest of the body. In other cases, the valve may not fully close, allowing blood to leak back into the heart chambers. Both of these situations cause the heart to work harder, reduce the amount of fresh blood in circulation, and may lead to more serious problems if left untreated.

Heart valve disease can be tricky. Occasionally, individuals with heart valve disease have no symptoms at all, and some may have symptoms that are so subtle or develop so gradually, they hardly notice them. So, what are some things to watch out for?

My Aortic Stenosis Confession: Susan

Signs and Symptoms of Heart Valve Disease

  • Murmur: This is the most common reason heart valve disease may be expected, and your doctor will likely be the one to discover it. It simply means that an unusual noise, often a whooshing or swishing sound, is heard when listening to your heart with a stethoscope.
  • Heart palpitations: Your heart may feel like it’s racing or skipping a beat. People often describe it as a fluttering or “flip flop” sensation.

  • Shortness of breath: You may feel like you can’t catch your breath or take in a full breath. You may also feel uncomfortable when lying down, but able to breathe easier if you prop yourself up with pillows.

  • Fatigue or difficulty maintaining regular activity: Everyone has days where they feel extra tired, but if you find yourself exhausted all of the time or don’t have the stamina to do the things you normally do, this could be a concern.

  • Swelling in the lower extremities and abdomen: Your feet, ankles, legs, and abdomen may appear puffy or bloated due to fluid retention.

  • Lightheadedness: You may feel dizzy or faint when you stand up or move.
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  • Chest pain: You may experience discomfort or pressure in your chest, especially with activity.

Keep in mind that all of these symptoms may also occur for reasons other than heart valve disease, and some of them may be harmless. But it is always a good idea to visit your doctor if you notice any of these developing or worsening.

Making a Diagnosis

There are a number of exams and tests your doctor may perform to determine if you have heart valve disease. treat it:

  • Physical exam: Your doctor will do a full head-to-toe exam to listen for a murmur and assess for any of the symptoms described above.

  • Echocardiogram: This test uses sound waves to create pictures of your heart and is the most common way to check for valve problems. The pictures from the test will show how your heart pumps blood and whether your valves are too narrow or are allowing blood to flow backwards. It can be done using a transducer, a wand-like probe that picks up the sound waves that bounce off your heart, that is placed on the outside of your chest, or if more detailed pictures are needed, the transducer may be passed down through your mouth into your esophagus after you have been sedated.

  • MRI or Magnetic Resonance Imaging: Magnet and radio waves are used to create images of your heart and valves as it pumps.

  • EKG or Electrocardiogram: Little stickers called electrodes are placed on your chest, and sometimes limbs, to show the electrical activity of your heart. Valve disease can generate recognizable patterns on the EKG.

  • Cardiac catheterization: A long flexible tube is placed into a large vein in your arm or leg and using x-rays is guided to your heart. A dye can be injected through the tube, so x-rays imaging can record how blood moves throughout your heart. This can provide information about how your valves are working, as well as the overall function of your heart.

  • Chest X-ray: This can show if your heart is enlarged and if you have fluid in your lungs. It may allow your doctor to see if there are calcium deposits on your heart or valves that sometimes occurs with valve disease.

Treating Heart Valve Disease

 Management of heart valve disease can range from simple to complex.

  • Lifestyle Changes: Make healthy changes to prevent further damage to your heart. Engage in regular exercise as directed by your doctor. Stop smoking. Try to reduce stress. Avoid fat- and cholesterol-laden foods.

  • Medication: Your doctor may order medication to lower your blood pressure and cholesterol. Anticoagulants, to prevent the formation of blood clots, are also frequently prescribed. You may require an anti-arrhythmic medication to keep your heart pumping at a normal rhythm.

  • Valve Repair: Sometimes your valve can be repaired by adding tissue, removing tissue, or widening the opening of the valve. For some patients, this can be done using a minimally invasive procedure with a long, flexible cardiac catheter. But for others, more extensive surgery is needed.

  • Valve Replacement: If the valve is too damaged, it may require replacement with a man-made or a biological valve made from a pig, cow, or human heart tissue. Similar to valve repair, depending on the individual patient factors, valve replacement may be done via traditional surgery or using a less invasive method. For example, transcatheter aortic valve replacement (TAVR) was recently approved for aortic stenosis patients who have a low, intermediate, or high risk of complications from traditional surgical aortic valve replacement (SAVR). Patients who undergo TAVR generally have less risk of infection, less pain, and shorter hospitalizations than those with open-heart surgery.

Finding out you have a disease that affects your heart can be scary. But many people continue to live long and full lives with heart valve disease as a result of lifestyle changes and medical treatments including medications and surgery. It is important to see your doctor regularly to be monitored for changes along the way.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Apr 10
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