Valve Disease

The two common types of aortic valve diseases are aortic insufficiency and aortic stenosis.

Aortic insufficiency Aortic insufficiency is a heart valve disease in which the aortic valve weakens or balloons, preventing the valve from closing tightly. This leads to backward flow of blood from the aorta (the largest blood vessel) into the left ventricle (the left lower chamber of the heart).

Risk factors

In the past, rheumatic fever was the primary cause of aortic insufficiency. Now that antibiotics are used to treat rheumatic fever, other causes are more commonly seen.

Other risk factors for valve problems include:

• ankylosing spondylitis
• aortic dissection
• endocarditis
• high blood pressure
• Marfan's syndrome
• Reiter's syndrome
• syphilis
• systemic lupus
• erythematosus
• valve problems that are present at birth

Symptoms

Patients with aortic insufficiency may present with one or several of the following symptoms or have no symptoms at all: chest pain under the sternum, which may radiate; crushing, squeezing, pressure, tightness; pain increases with exercise, relieves with rest. fainting fatigue irregular, rapid, racing, pounding or fluttering pulse palpitations pulse, pounding shortness of breath weakness

Aortic stenosis is the narrowing or obstruction of the heart's aortic valve, which prevents it from opening properly and blocks the flow of blood from the left ventricle to the aorta. Risk factors Aortic stenosis may be present from birth (congenital), or it may develop later in life (acquired).

Other risk factors include:

• hypertension
• male gender
• rheumatic fever
• Symptoms
• breathlessness with activity
• chest pain, angina–type under the sternum, may radiate; crushing, squeezing, pressure, tightness; increased with exercise, relieved with rest
• dizziness fainting or weakness with activity reduced stamina, fatigue palpitations

Diagnostic Tools

Many tests are used to diagnose aortic valve disease. Usually, more than one test will be done before a definitive diagnosis can be made. These tests may include:

• physical examination and patient history
• ECG chest X–ray echocardiogram
• cardiac catheterization and coronary angiography cardiac CT angiography

Treatment Options

Heart valve surgery can be used to replace or repair damaged aortic valves: aortic valve repair surgery corrects aortic insufficiency; the damaged valve is strengthened and shortened to help the valve close more tightly. Aortic valve replacement surgery corrects both aortic stenosis and insufficiency. Surgeons may consider replacing the original valve with either: mechanical valves, created from man–made materials, which require long-term blood thinning with warfarin medication. biological (tissue) valves

Prevention Steps to prevent or to reduce the risk of aortic stenosis include:

• telling your health care provider if there is a family history of congenital heart diseases
• telling your health care provider about any history of heart valve disease consider treatment of elevated cholesterol which may prevent or delay worsening of aortic stenosis

Mitral stenosis is a narrowing or obstruction of the opening of the mitral valve, which separates the upper and lower chambers on the left side of the heart. This prevents adequate blood flow between the left atrium (upper chamber) and ventricle (lower chamber).

Risk factors

Risk factors for mitral valve stenosis include rheumatic fever. Since rheumatic fever rates are declining in the United States, the incidence of mitral stenosis is also decreasing. Only rarely do other disorders cause mitral stenosis

Symptoms

Patients may present with no symptoms, or the following symptoms may appear or worsen with exercise or increase in heart rate:

• chest discomfort
• cough
• difficulty breathing
• fatigue
• frequent respiratory infections
• palpitations
• swelling of feet or ankles

Diagnostic Tools

Many tests are used to diagnose mitral valve disease. Usually, more than one test is done before a definitive diagnosis can be made. These tests may include:

• physical examination and patient history
• ECG chest X–ray echocardiogram
• cardiac catheterization and coronary angiography cardiac CT
• angiography

Treatment Options

Heart valve surgery can be used to replace or repair damaged mitral valves:

Mitral valve repair surgery corrects mitral valve insufficiency; the damaged valve is strengthened and shortened to help the valve close more tightly Mitral valve replacement surgery corrects both mitral stenosis and insufficiency Surgeons may consider replacing the original valve with either: Mechanical valves created from manmade materials, which require long-term blood thinning with warfarin medication Biological (tissue) valves.

Prevention

Mitral stenosis itself often cannot be prevented, but its complications may be prevented. Preventive measures to limit complications may include: informing your health care provider of any history of heart valve disease before medical treatment taking anticoagulation medication as prescribed telling your health care provider if you have a family history of congenital heart diseases or valve disease treating strep infections promptly to prevent rheumatic fever