Valve Disorders

Symptoms of heart valve disease can vary widely, depending on the specific condition and age of the individual.   

• In children: Symptoms may be present at birth or appear later. These include:
  • Difficulty gaining weight and feeding issues
  • Blue skin tone, particularly on the lips, fingers and toes
  • Low blood oxygen levels, detectable via pulse oximetry
  • Signs of shock, such as pale skin, rapid breathing and weak pulse

If your child exhibits feeding difficulties, blue skin tone or signs of shock, seek medical help immediately.

• In adults: Symptoms may develop slowly, often mistaken for signs of aging, or may not appear at all until the condition becomes severe. Symptoms include:
  • Breathing difficulties, especially during physical exertion
  • Chest pain or discomfort (angina)
  • Dizziness or fainting spells
  • Fatigue
  • Fever, possibly indicating an infection that can lead to endocarditis
  • Rapid or irregular heartbeat
  • Swelling around the eyes, ankles or abdomen

Heart valve problems can be either congenital (present at birth) or acquired over time:

Congenital Heart Valve Diseases

These conditions develop while a baby is in the womb, often due to improper formation of the heart and its valves. These congenital defects can vary widely, from mild issues that may go unnoticed for years to severe malformations that are life-threatening. For instance, some babies may be born without a functional heart valve (atresia), or with valves that are too narrow (stenosis) or too leaky (regurgitation). Certain congenital valve diseases are inherited, meaning they are caused by genetic factors passed down from parents to children. An example is bicuspid aortic valve, a condition where the aortic valve has two leaflets instead of three, leading to stenosis.

Acquired heart valve diseases

As we age, or due to specific health conditions or lifestyle factors, we may develop heart valve diseases. These acquired conditions can stem from damage to the valves or the supporting structures due to a heart attack, the wear and tear of aging, or infections like endocarditis.

Key risk factors include:

• Age: Older adults are at higher risk, particularly with lifestyle factors that increase the risk.
• Family history: Conditions like mitral valve prolapse or bicuspid aortic valve can run in families. A family history of early coronary heart disease can raise your risk of developing a heart valve disease.
• Lifestyle habits: Lack of physical activity, poor diet, smoking, recreational drug use and obesity increase risk.
• Medical devices: Pacemakers and defibrillators, while lifesaving, can sometimes cause complications, such as scarring or stretching of the valves.
• Other medical conditions: High blood pressure, diabetes, autoimmune disorders and previous rheumatic disease increase the risk.
• Cancer treatment: Radiation therapy for cancer, especially if it involves the chest area, can lead to thickening and narrowing of the heart valves.
• Sex: Certain valve conditions, like aortic stenosis, are more common in men. 

Diagnosing heart valve disease involves a comprehensive approach, starting with a detailed review of your medical history and symptoms, followed by a physical examination and various diagnostic tests. Your healthcare provider will assess your risk factors, ask about any symptoms you may have and inquire about any family history of heart valve conditions.

During the physical examination, your doctor may:

• Listen to your heart: Using a stethoscope, the doctor will listen for abnormal heart sounds, such as a murmur or irregular rhythm, which can indicate a valve problem.
• Check your pulse: The doctor will feel the strength and rhythm of your pulse in your neck or arm to assess heart function.

The most common and effective test for diagnosing heart valve problems is Echocardiography (Echo):

• Echocardiogram: This non-invasive test uses sound waves to create moving images of your heart. The Echo can show the size and shape of your heart, the condition of the four valves, and how well your heart is pumping blood. A specialized form of Echo, called Doppler ultrasound, measures how well blood flows through the heart’s chambers and valves. Echo is particularly useful for identifying the cause of abnormal heart sounds, like murmurs, and for assessing how well your heart responds to certain treatments.

In addition to an Echo, your doctor may recommend other diagnostic tests, including:

• Electrocardiogram (ECG or EKG): This simple, painless test records the electrical activity of your heart. An EKG can reveal how fast your heart is beating, whether the rhythm is steady or irregular, and how the electrical impulses are moving through your heart. EKGs are commonly performed in a doctor’s office, hospital or during a stress test.
• Chest X-ray: This imaging test provides a detailed look at the structures in and around your chest, including the heart and lungs. An X-ray might also detect calcium buildup on a heart valve or fluid in the lungs due to abnormal heart valve function and heart failure.  
• Stress test: A stress test evaluates how well your heart functions under physical stress, such as exercise. This test is particularly useful for identifying heart problems that may not be apparent at rest. During a stress test, you may be asked to walk on a treadmill or ride a stationary bike while your heart rate, blood pressure and breathing are monitored. If you are unable to exercise, your doctor may give you medication that mimics the effects of exercise on your heart. Stress tests can help your doctor determine the severity of your heart valve disease and guide treatment decisions. 

While not all heart valve diseases can be prevented, there are steps you can take to reduce your risk or prevent existing conditions from worsening:

• Adopt a heart-healthy lifestyle: This includes eating a balanced diet, exercising regularly, maintaining a healthy weight, quitting smoking, and managing stress.
• Practice good hygiene: Maintaining good oral and skin hygiene can help prevent infections that could lead to endocarditis, a serious condition that can damage heart valves.
• Follow your doctor’s advice: Take prescribed medications as directed, attend regular checkups, and seek prompt treatment for infections like strep throat to prevent complications such as rheumatic fever, which can damage heart valves.

For expectant mothers, it’s important to talk to your doctor about steps you can take to protect your baby’s heart health, including taking prenatal vitamins and avoiding infections like rubella during pregnancy.