Heart valves act as a kind of valve of the engine heart: they ensure that the blood always flows in the right direction and does not flow back to where it just came from. A heart valve defect prevents this function and can have fatal consequences. Subforms in heart valve defects are heart valve insufficiency or heart valve weakness.
What is a heart valve defect?
The human heart has a total of four heart valves: The aortic and mitral valves are the most commonly affected by heart valve defects. A heart valve defect is a functional disorder of the heart that is either congenital or can be acquired – for example, through disease. There are different types of heart valve defects: The so-called stenosis represents a narrowing of the heart valve that prevents the blood from flowing through it. In the case of insufficiency, the heart valve closes only incompletely, allowing blood to flow back. When doctors speak of combined vitium, they mean a combination of the first two heart valve defects.
Causes
In most cases, a heart valve defect is congenital. Sometimes, however, one can acquire one, such as through disease. There are a variety of diseases that can result in a heart valve defect. A flu that has not been cured is also one of them. Therefore, it is absolutely necessary to refrain from endurance training in the case of influenza, but also only in the case of a severe cold, and to take it easy instead. If you go jogging with a severe cold, this can lead to a dramatic undersupply of oxygen to the blood, even in young, well-trained people. As a result, the heart has to pump harder and can become so overloaded due to the disease that one or more heart valves no longer close properly. In other cases, the heart valves degenerate, mainly due to age: With increasing age, not only the blood vessels calcify, but also the heart valves. This process usually results in narrowing of the heart valves. Another common cause of heart valve defects is inflammation of the same caused by bacteria, for example.
Symptoms, complaints, and signs
Symptoms vary significantly according to the severity, location, and type of valvular defect. Many valvular heart defects go unnoticed for a long time because they do not initially cause symptoms. However, in some, such as mitral valve stenosis, very obvious symptoms can occur acutely. In principle, the heart can compensate for most valve defects over a long period of time. However, this leads to heart failure (cardiac insufficiency) in the longer term. In some cases, valvular defects are not noticed until then. A typical symptom is a feeling of tightness and strong pressure in the chest area. This occurs especially during physical exertion. In addition, many affected individuals suffer from rapid fatigue and a general feeling of exhaustion. Their performance and concentration can decrease significantly. Dizziness and brief fainting spells (syncope) are common. The specific symptoms that occur also depend on whether the valvular defect affects the left or right ventricle. Valve defects in the left ventricle cause symptoms that can resemble those of bronchitis. These include shortness of breath and a strong urge to cough (especially at night). Sufferers feel more comfortable in upright positions than lying down. In the longer term, cardiac arrhythmias often occur. If the right heart valve is affected, there is water retention in the legs and abdomen, a blue discoloration of the skin, shortness of breath, and liver pain.
Diagnosis and progression
Mild valvular heart defects are usually discovered only by chance and usually do not require treatment. They are usually asymptomatic. However, typical signs of severe valvular defects may include shortness of breath, a feeling of tightness in the chest, and high blood pressure. Sometimes fainting spells can occur. Heart valve defects are diagnosed by ECG and ultrasound. During ultrasound, the cardiologist (i.e., a doctor who specializes in the human heart) examines blood flows and checks to see if they are flowing as they should. The ECG (also called an electrocardiogram or heart chart) is performed as either a 24-hour ECG or stress ECG. In the case of a 24-hour ECG, the patient is given 4 electrodes taped to the skin, which are connected to a small box about the size of a walkman.The box is attached to the hip. The ECG then measures heart activity during a normal daily routine. Cardiac arrhythmias and suspicious sounds are also an indication of a heart valve defect.
Complications
The valvular defect can lead to heart failure and death of the patient. Usually, life expectancy is significantly reduced by the valvular heart defect if treatment for this condition does not occur. The affected person suffers from severe high blood pressure as a result of the defect and thus also an increased risk of heart attack. Furthermore, the patient may experience shortness of breath during exertion, leading to sweating or panic attacks. The general resilience of the patient decreases enormously and cardiac arrhythmias develop. These have a very negative effect on the patient’s everyday life and lead to a reduced quality of life. In some cases, patients lose consciousness completely or may die from respiratory distress. It is also not uncommon for psychological complaints or depression to occur. The heart valve defect can only be eliminated with the help of a surgical intervention. In this case, an artificial valve is used, whereby there are usually no particular complications. In severe cases, inflammation may occur after the operation. Therefore, the patient must also take antibiotics to prevent this inflammation. If the treatment is successful, there is no reduction in life expectancy.
When should you go to the doctor?
If symptoms such as shortness of breath, high blood pressure, or a decrease in performance are noticed, there may be an underlying heart valve defect. A visit to the doctor is recommended if the symptoms persist over a longer period of time. If other symptoms occur, such as signs of heart failure or a general decline in well-being, medical advice is also required. In the event of impaired consciousness or fainting, it is best to call an emergency doctor or take the patient to the nearest hospital immediately. The same applies to acute heart pain and severe shortness of breath. If cardiac arrhythmia is suspected, this must also be clarified by a doctor and treated if necessary. Elderly people and people who may have had a badly cured flu are particularly at risk of a heart defect. Viral infections, tumor diseases and other illnesses can also cause a heart valve defect. Anyone who belongs to these risk groups should talk to their family doctor if they have any of the symptoms mentioned above. Further treatment is usually provided by a cardiologist or an internist. In most cases, therapeutic advice is also useful, since a heart valve defect can place a considerable strain on the psyche.
Treatment and therapy
A heart valve defect cannot be eliminated by administering medication. Surgery is usually necessary. Sometimes the patient’s own diseased valve can be reconstructed, but in cases of severe valve defects, the damaged valve is replaced. Instead, the patient receives an artificial valve. If a heart valve has become too narrow, for example due to calcification, it can also be dilated. This is done with the help of a balloon, which is folded up and placed at the appropriate location and then gradually dilated. However, this procedure is only possible in rare cases. In heart valve patients, any bacterial infection can be dangerous, as it may lead to inflammation of the heart. For this reason, antibiotics are often given as a preventive measure.
Outlook and prognosis
The prognosis of valvular heart disease depends on the valve affected as well as the progression of the disease. A potentially poor prognosis is present once the patient’s heart function is impaired. A large valvular defect also carries an increased risk of unfavorable disease progression. Surgical intervention is necessary to ensure the patient’s survival. If the operation is successful, the patient can lead a good life despite the disease. Nevertheless, the quality of life is limited and secondary diseases are possible. These are mostly from the psychotherapeutic field, since an inevitable change in the current lifestyle and restriction of the usual possibilities for health reasons leads to mental suffering in many people.A minor or mild valvular heart defect is treated with medication in most cases. Lifestyle must also be restricted and changed to avoid a life-threatening health condition. In principle, patients with a valvular heart defect must undergo regular medical check-ups, as the heart’s activity can deteriorate at any time. There is a lifelong possibility that an increase in symptoms will develop and a failure of the heart to function will occur. If left untreated, the patient with a valvular heart defect is at risk of premature death. Cardiac activity is impaired and can cause a sudden acute health-threatening condition.
Prevention
Those who want to prevent a heart valve defect should change their diet: Plenty of fruits and vegetables, but little fat and meat, will ensure good heart health. Normal blood pressure (120 over 80 is optimal) and avoiding excess weight also contribute to good health. Plenty of exercise in fresh air helps. If you are ill, however, exercise should be avoided. Bed rest is urgently necessary here. Often, however, an infection caused by bacteria can result in a heart valve defect. Streptococci in particular become dangerous to humans in this case.
Aftercare
Medical follow-up after heart valve surgery is essential. Usually, a stay in the hospital is followed by a course of treatment. Because the patient is required to take anticoagulant medications, regular follow-up examinations should be performed. In the case of bio-valves, this is required for a period of three to six months; in the case of artificial valves, these drugs should be taken for the rest of the patient’s life. It is important for patients to test or monitor themselves after surgery and to see their doctor immediately if their body shows any warning signs. By taking a blood count, any inflammation levels will be detected. High-risk patients should be given antibiotics to prevent bacterial infections. Intensive dental hygiene and careful wound disinfection in the throat area play an important role. In the first weeks after the surgical procedure, twisting movements and transverse loads on the chest and heavy work should be avoided. Shorter air trips are possible, but long-distance travel is not recommended for up to six months after the operation. Sports activities should initially be limited to light walking, cycling and swimming. If chest pain occurs or the patient finds the feeling of constriction disturbing, it is advisable to consult the attending physician. Echo tests in these cases are a method to diagnose possible disorders after heart valve surgery.
What you can do yourself
Once a heart valve defect has been diagnosed, lifestyle changes usually need to be made. The doctor will recommend a healthy diet and regular exercise to the patient. In addition, stimulants such as cigarettes, alcohol and coffee should be avoided. Patients who are overweight must take measures to regain a normal body weight in the long term. Accompanying physiotherapy, which is usually recommended to patients with heart valve defects anyway, are sports such as swimming or aqua jogging. Activities that put a lot of strain on the body, on the other hand, should be discontinued. These include bodybuilding and martial arts, but also stressful situations at work. oIf symptoms such as a twinge in the area of the heart, shortness of breath or a tingling sensation in the right arm suddenly develop, the emergency services must be called immediately. In most cases, this is a medical emergency that requires immediate medical treatment. If the symptoms recur, a heart valve defect must be operated on. After such an operation, the patient must take it easy and stay in bed. The heart must not be stressed in the first period after the operation and must be examined regularly in order to exclude complications. The doctor will advise the patient on individual measures to make everyday life with a heart valve defect easier.
