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Valvular Heart Disease - Heart Valve Disease 

Introduction
Heart valve disease occurs when the valves that control the direction of the blood flow through the heart do not open and close, as they should.  This can cause the heart to work harder and enlarge.  Eventually, heart valve disease can lead to heart failure and death.  Fortunately, surgical heart valve replacement is highly successful for treating valvular heart disease.

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Anatomy
The heart is the core of the cardiovascular system.  Your cardiovascular system consists of your heart and the blood vessels that carry blood throughout your body.  Your heart is located to the left of the middle of your chest.  Your heart is a large muscle is about the size of your fist.  It works as a pump.  The blood carries nutrients and oxygen that your body cells need for energy.  It also carries waste products away.
Your heart is divided into four sections called chambers.  The chambers are separated by the septum, a thick muscle wall.  The two top chambers are called atria, and they receive blood coming into the heart.  The two bottom chambers are called ventricles, and they send blood out from the heart.
 
Your heart contains two pumping systems, one on its left side and one on its right side.  The left-sided pumping system consists of the left atrium and the left ventricle.  Your left atrium receives blood that contains oxygen, which comes from your lungs.  Whenever you inhale, your lungs move oxygen into your blood.  The oxygenated blood moves from the left atrium to the left ventricle.  The left ventricle sends the oxygenated blood out from your heart to circulate throughout your body.
 
The heart’s right-sided pumping system consists of the right atrium and the right ventricle.  Your right atrium receives deoxygenated blood, blood that has circulated throughout your body and does not have high levels of oxygen in it anymore.  The deoxygenated blood moves from the right atrium to the right ventricle.  The right ventricle sends the blood to the lungs where it receives oxygen when you breathe.
 
As the blood travels through the heart chambers, four valves keep the blood from back flowing.  The mitral valve and the tricuspid valve regulate blood flow from the atria to the ventricles.  The aortic valve and the pulmonary valve control blood as it leaves the ventricles.
 
Your doctor will listen to your heartbeat with a stethoscope.  A healthy heart makes a lub-dub sound each time it beats.  The first sound in your heartbeat occurs when the mitral valve and the tricuspid valve close.  The second sound in your heartbeat occurs when the aortic valve and the pulmonary valve close after the blood leaves your heart.  

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Causes
Valvular heart disease can affect all four valves of the heart.  The heart valves normally open and close to control the way blood flows through your heart.  The regular opening and closing of the valves produces a regular heartbeat.  With valvular heart disease, the valves do not open and close properly.  The valves may leak or the blood may back up into the heart chambers.  This can cause the heart to work harder to pump the blood out of the heart.  This may cause a heart murmur and overtime, lead to an enlarged heart or heart failure.

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Symptoms
The symptoms of heart valve disease are similar to those of congestive heart failure.  You may experience shortness of breath after activities or lying down.  Your arms, legs, abdomen, and ankles may swell and feel cool.  You may develop an irregular heartbeat.  You may have indigestion, nausea, vomiting, and loss of appetite.  You may feel weak, faint, or very tired.  You may feel the beat of your heart (palpitations) and have an irregular or fast pulse.  You may have difficulty sleeping, remaining alert, concentrating, and remembering things.  You may sweat a lot.  You may cough, especially at night.  You may produce smaller amounts of urine than usual and may need to urinate more frequently at night. 

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Diagnosis
Your doctor can begin to diagnose heart valve disease by reviewing your medical history and conducting a physical examination and some tests.  Your doctor will use a stethoscope to listen to your heart to hear if you have a heart murmur.  There are several tests that can be used to diagnose heart valve disease.
 
Your doctor may order a chest X-ray to view an image of your heart and the size of your heart chambers.  An electrocardiogram (ECG) is used to record your heart’s electrical activity and detect abnormal heart rhythms.  An echocardiogram uses sound waves to produce an image of the heart on a monitor.  An echocardiogram can show the amount of heart valve leakage.  Cardiac catheterization involves inserting a long narrow tube through a blood vessel into the heart to see and evaluate the heart valves, muscles, and arteries.  

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Treatment
The type of treatment that you receive depends on the severity and extent of your valvular heart disease.  In some cases, treatment may not be necessary and the condition is carefully monitored.  Medications may be used to improve heart functioning, but medications do not cure valvular heart disease.  Heart valve surgery may be necessary to treat narrowed or leaking heart valves.

Heart valve surgery is an open-heart surgery that is performed under general anesthesia.  Heart valves may be replaced or repaired.  Replacement valves may be artificial or from donors.  Heart valve surgery is highly successful.  It can relieve your symptoms and help you to live a longer life. 

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Prevention
Depending on the type of surgery you receive, you may need to take antibiotics before you have dental procedures or future surgeries.  Your doctor will let you know what to expect.

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Am I at Risk
Heart valve disease can be present from birth.  It may result from rheumatic heart disease, endocarditis, or weakened heart muscles.  The valves may be injured as the result of a heart attack.  Valve problems may be caused by certain medications, such as Fen-Phen.

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Complications
Untreated heart valve disease can lead to heart failure and death.  It is important to contact your doctor immediately if you experience the symptoms of heart valve disease.  Surgical treatment is highly effective for treating this condition.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.