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Heart Valve Disease

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Heart Valve Disease• Valvular heart disease• Valves make sure blood flows in a

forward direction– no backward leakage

• Tricuspid and mitral valves• Pulmonic and aortic valves

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Valvular Stenosis• Opening is smaller than normal• Heart may have to work very hard• Conditions

– tricuspid stenosis– pulmonic stenosis– mitral stenosis– aortic stenosis

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Valvular Insufficiency• Same as regurgitation

– Incompetence– Leaky valve

• Conditions– tricuspid regurgitation– pulmonary regurgitation– mitral regurgitation– aortic regurgitation

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Causes• Congenital

• Acquired

• Unknown

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Congenital Valve Disease• Wrong size• Malformed leaflets (flaps)• Attached incorrectly

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Acquired Valve Disease• Problems develop with valves that

were once normal• Changes in structure due to a

variety of diseases or infections– rheumatic fever– endocarditis

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Mitral Valve Prolapse• MVP• Very common

– 1% to 2% of the population• Leaflets of mitral valve flop back

into the left atrium• Rarely causes symptoms• Usually doesn’t require treatment

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Symptoms• Shortness of breath• Weakness or dizziness• Chest discomfort• Palpitations• Swelling• Rapid weight gain

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Symptoms do not always

relate to the seriousness

of the valve disease!!

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MurmurA swishing sound made by

blood flowing through a

stenotic or leaky valve

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Tests• Echocardiogram

– TTE (TT = trans thoracic)– TEE (TE = trans esophageal)

• Cardiac catheterization• Radionuclide scans• MRI

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Goals of Treatment• Protect valve from further damage

• Lessen symptoms

• Repair or replace valve

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Common Medications• Diuretics (water

pills)

• Antiarrhymthmics

• Vasodilators

• ACE inhibitors

• Beta blockers

• Anticoagulants (blood thinners)

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Repair• Percutaneous balloon valvotomy

• Open commisurotomy

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Replacement• Mechanical heart valve

– made from plastic or metal

• Bioprosthetic heart valve– made from human or animal (usually

pig) tissue

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Comparison• Mechanical valve

– More likely to cause clots

– Must take anticoagulants

– Usually for people younger than 70

• Bioprosthetic valve– Does not require

anticoagulants– Not as sturdy– Replace after 10

years– People older than

70

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With either type of valve

replacement, there is a

risk for a heart infection

(endocarditis).