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Failure of the Natural Valve

Opening and closing all day is not an easy task. Try opening your mouth 70 times per minute. If your jaw doesn't fall off first, you might just have the slightest insight into the life of a heart valve. If your jaw does fall off it's not my fault. The point is that the valves of the heart are specially designed to do what they do, and consequently, small changes in the tissue or surrounding environment can have disastrous effects on valve performance and the function of the entire heart.

There are two main types of valve dysfunction - stenosis and regurgitation. A stenotic valve has lost the ability to open fully, while a regurgitating valve has lost the ability to form a tight seal upon closure. Disorders of the valve requiring intervention most often occur in the left side of the heart. Below are some common types of valve disease:

Valves that Call Earl

Aortic Regurgitation -Widening of the Aortic ring causing incomplete closure of the aortic annulus during diastole.

Symptoms: Shortness of breath, Chest pain, Ankle swelling,

Causes: Infection, Rhematic Fever, Marfan Syndrome

Treatment: Valve replacement

Mitral Regurgitation - Back flow of blood through the Mitral valve decreases the amount of fresh blood received by the tissues.

Symptoms: Fatigue, Shortness of breath. Symptoms are often mild but in extreme cases can require valve replacement.

Causes: Rheumatic Heart Disease, Heart Attack, Rupture of Chordae Tendinae, Dysfunction of Papillary muscles.

Treatment: Drugs, Valve replacement

Mitral Prolapse - Most common type of valve disease in which a bulging or displaced valve does not close properly. It can result in regurgitation through the valve. This condition is know by various aliases - floppy valve syndrome, balloon mitral valve, and click-murmur syndrome to name a few.

Symptoms: Similar to Mitral Regurgitation (generally mild), tachycardia, Asymptomatic

Causes: Hereditary

Treatment: Valve replacement (extreme cases)

Valvular Constipation

Aortic Stenosis - The inability of the aortic valve to open fully causes the left ventricle to pump against greater pressures.

Symptoms: Fatigue, Shortness of breath, Fainting, Angina (especially occurring with exercise)

Causes: Calcification, Rhematic Fever, Congenital defect (rare)

Treatment: surgical repair

Mitral Stenosis - Partial opening of the Mitral valve increases the pressure against which the left atrium pumps. The extra pressure causes fluid to be retained in the lungs and can result in congestive heart failure.

Symptoms: Build up of fluid in lungs, Shortness of breath

Causes: Rheumatic Fever (primarily)

Treatment: Valvuloplasty (surgical widening of the valve)

Summary of the Causes of Valve Failure:

Rheumatic Fever
Myxomatous Degeneration
Congenital Defects
Endocarditis
Heart disease
Calcific Degeneration

Valve replacement is reccommended when the valvular disease has progressed to the point where it is thought to be life threatening. Replacing a valve, as we will see, however, is no easy task.