Increasing shortness of breath under physical exertion – many sufferers think this is a normal symptom of old age. However, this symptom can be a warning signal for a disease of the heart valves. This thus often remains undetected for years until irrevocable damage to the heart muscle is finally present.
Things to know about the heart
The heart is about the size of our fist and weighs about 300 grams in adults. It is a hollow organ – that is, a cavity enclosed by muscles and other tissues. The heart consists of two chambers (ventricles) and two atria (atria). The two chambers of the heart are each filled with blood via an inlet valve and each emptied via an outlet valve – the total of four heart valves. Depending on their shape, these are divided into leaflet and semilunar valves. The leaflet valves are located between the atria and ventricles, while the pocket valves are located at the outlet of the two ventricles.
Tasks of the heart valves:
- Prevent the backflow of blood into the ventricle and atrium
- Determine the direction of blood flow and ensure a uniform blood flow
Heart valve disease
With increasing age, more and more people suffer from a disorder of the heart valve function: due to narrowing, calcification or leakage, the blood flow is obstructed. With leaky valves, blood flows partially back through the valve after each heartbeat; with narrowed valves, it backs up in front of the valve and the heart has to pump more. Initially, the heart tries to cope with this additional load by taking compensatory measures, for example by building up more muscle. In the long term, however, this leads to heart failure (cardiac insufficiency) and even heart failure.
Forms of valvular heart disease:
- Valve stenosis (narrowing).
- Valve leakage (insufficiency)
- Combined valve defect (leakage and narrowing).
Heart valve defects are predominantly acquired during life. With today’s high life expectancy, valve defects are in the foreground, which are due to “wear and tear”. The valves wear out over a long life. This can cause them to narrow or become unable to close. Other valvular defects occur as a result of inflammation of the valves due to acute rheumatic fever, bacterial valvulitis, or as a result of heart disease, such as a heart attack. They can also occur in middle and young age. Congenital heart valve defects are very rare, occurring in only about 3 percent of all people.
Symptoms and symptoms
The earlier heart valve disease is detected, the more effectively therapeutic methods can be used. It is therefore desirable that those affected recognize the warning signals as such and not dismiss them as trivial. It is true that many of those affected notice sooner or later that they are less able to work under pressure than they used to be. Since the disease usually worsens only slowly, there is no sudden drop in performance, but the symptoms increase gradually. And this is often mistakenly understood as a normal process of aging. Defective valves can lead to a reduced pumping capacity of the heart – especially under stress. For this reason, one should become alert if increased breathing or even shortness of breath occurs even during a walk or other light exertion. However, one should not only be vigilant in the case of reduced performance. Depending on the type of heart valve defect, brief fainting spells, chest pain, water retention in the legs, or a sharp increase in heart rate under even light exertion may also occur.
Diagnosis of valvular heart disease
Whether valve disease is actually responsible for existing symptoms should be clarified in any case with a short visit to the doctor, who listens to the chest with a stethoscope for noticeable sounds of the heart valves. An ultrasound examination (echocardiography), which provides a precise view of the heart and does not require X-rays, ensures an exact diagnosis.
Therapy of heart valve defects
Various treatment options are available, depending on the type and severity of the valve defect. For low-grade defects, often only the symptoms are initially treated with medication. If this is not (or no longer) sufficiently possible, surgery is usually the next step – preferably before the heart muscle has changed irrevocably.Possible procedures include valve disruption through cardiac catheterization (for narrowing), valve reconstruction, in which the valve is repaired, or valve replacement, in which the defective valve is replaced with a new one (made of plastic, metal, graphite, or human or animal tissue). The last two procedures are performed under general anesthesia, as the chest must be opened for them. The physician assesses when such an operation is necessary in order to increase performance and gain lifespan. Although there are risks, these are usually justified by the prospects of success: Quality of life improves significantly, and even preexisting heart failure often regresses.
