Overview of Heart Valvular Diseases

What are the Heart Valves?

Your heart valves are four small gatekeepers which control the flow of blood in your heart every time it beats.

These valves are four small flaps which open and close with every beat.

The Pulmonary and Tricuspid valves allow deoxygenated blood (blood without oxygen in it) to come back to the heart and then be sent to the lungs.

The Aortic and Mitral valves allow oxygen-rich blood from the lungs to flow into the heart to then pump to the rest of the body.

What is it?

Heart valve diseases occur when your valves aren’t opening and closing properly, often due to two conditions:

Regurgitation: regurgitation is where your valves do not close tight enough, causing blood to leak back into the chambers of your heart rather than pumping forward.

Stenosis: stenosis of your valves is a condition where your leaflets on your valve can either stiffen or fuse together, making it harder for blood to flow through.

The Mitral and Aortic valves are the two valves which are commonly affected by regurgitation and stenosis .

Causes

There are many varied causes for Heart Valve disease, some are a result of other conditions, some are due to your genetic factors.

These are the most common causes of Heart Valve Diseases:

Ageing: as we grow older, we have increased levels of calcium in the body which can then sit on the valves. the valves then become thick and stiff, also known as stenosis.

Birth/congenital defects: some people are born with valves that are a different size or shape. for example, you may be born with two leaflets instead of three.

Infection: there are some infection types which can result in your valves becoming damaged. These conditions include rheumatic heart disease and endocarditis.

Heart Failure: when your heart increases in size the valve may also be impacted.

Heart attack: if you have a heart attack you can potentially damage the heart valves.

Statistics

  • At least 10 valve repair/replacement procedures were performed per day on Australian women in 2015-16.
  • Around 15 Australian women per day had a hospitalisation for Congenital and Rheumatic Heart valve diseases between 2015-16.

Symptoms

Signs and Symptoms

There are many signs and symptoms of Heart Valve Diseases:

  • Feeling weak, tired and fatigued
  • Coughing
  • Rapid weight gain
  • Short of breath
  • Angina (chest pain)
  • Swollen ankles
  • Dizziness
  • Fainting
  • Fluttering in the chest
  • Abdominal bloating

Risk Factors

Risk Factors

The risk factors for Heart Valve Diseases are similar to the causes of Heart Valve Disease:

Age: as you grow older the valves in your heart become stiffer and thicker, which can lead to your heart valves becoming diseased.

Infections in the Heart: rheumatic fever, infective endocarditis as well as infections from intravenous drug use.

Congenital heart valves: if you’re born with a valve that has two leaflets instead of three you are more likely to have a valve disease in the future.

Coronary artery disease risk factors: if you also have risk factors for coronary artery disease you are also at an increased risk of heart valve diseases. These risk factors include being overweight or obese, diabetic, high blood pressure, high cholesterol, family history of heart disease and a sedentary lifestyle.

Treatment for Heart Valve Diseases

Depending on the severity of your Heart Valve Disease, you may be able to manage your condition with medications and healthy lifestyle changes.

However, there are times where you may eventually need to consider having surgical treatment to have your valve replaced or repaired.

Medications: medications are best taken in conjunction with lifestyle changes. Here is a list of the medications you may need to take:

Blood thinners:

these may be required if your valve problem places you at an increased risk of clotting, or if you have had a man-made valve inserted to replace your damaged valve.

Blood pressure and blood cholesterol lowering medications: these medications are important if your valve issue has also occurred with high blood pressure and high cholesterol

Antiarrhythmic medication:

these medications help reduce your heart being in an abnormal rhythm

Heart failure medications:

these can include diuretics (medications to get rid of excess fluid); typically, these medications are given to reduce the workload on your heart

Surgical treatments:

it can be necessary to repair or replace your heart valve to not only prevent further damage but reduce the likelihood of having a sudden cardiac event.

There are different surgical options for women with heart valves that need treatment:

Valve repair:

Valve repairs are procedures where surgeon try to repair your valve without implanting a new valve. For example, your surgeon could attach devices such as annuloplasty rings to help your valve stay open.

Valve repairs are commonly completed as open-heart surgery under general anaesthetic.

If you have a valve repair surgery, you are at lower risk of infection and will not need life-long blood thinners, however, it is not always possible to repair a valve.

Valve replacement:

sometimes your valve may need to be entirely replaced instead of repaired. if that is the case, a new, artificial valve will be sewn into a layer of tissue from your old valve.

There are two types of artificial heart valves, your doctor will suggest which is the best option for you. The two types are biological (made from pig or cow tissue) and mechanical (made from metal). Your doctor will discuss these options as well as any changes to medications .

Transcatheter Aortic Valve Implantation (TAVI):

If you have a damaged Aortic valve, a TAVI procedure is an option your doctor may suggest.

The procedure is minimally invasive, with a valve made from animal tissue being placed into your damaged valve if it has stenosed (stiffened and thickened) from calcium.

A TAVI procedure is suggested for people who would be considered too high-risk for open heart surgery.

Mitral Clip:

this is a minimally invasive procedure used to repair your Mitral Valve if it is experiencing regurgitation (when blood flows the wrong way due to the valves not closing properly).

In the procedure, a clip is placed on the valve (where it is not closing properly), whilst the functioning part of the valve continues as normally.

Balloon Valvuloplasty:

if your aortic valve is thickened and stenosed, your doctor may suggest a Balloon Valvuloplasty.

The procedure is minimally invasive and typically involves widening your valve using a balloon. Whilst this procedure can provide some symptom relief for Heart Valve Disease, it may not cure valve disease and you most likely will need medications and possibly surgery in the future.

We recommend speaking to your doctor about your options.

Prevention and Support

Follow the links below to find out more about how you can help prevent and support loved ones who have experienced Heart Valvular Diseases

Prevention

Prevention

You can lower your changes of valvular heart disease through several methods.
Supporters

Supporters

A support group is a good way to meet other people who have Heart Valvular Diseases
Carers

Carers

If you are struggling to care for a loved one, discuss how you feel with someone today.

FAQs

What you need to know

Women are more prone than men to having a valve disease acquired by rheumatic fever and strep infections, so it is recommended that you seek medical help if displaying signs of infection.

The signs and symptoms of rheumatic fever include: feeling tired, a prolonged sore throat (around 2-6 weeks), joint pain, muscle aches, fever and sometimes a rash on your chest, abdomen, arms and/or legs.

If you wish to become pregnant and have mild-moderate disease in your heart valve/s your doctor can discuss managing your condition with medications which will be safe for you and your baby.

However, if your valve disease is severe, you put your pregnancy at risk and doctors recommend you have your heart valve surgically treated and repaired first.

As mentioned earlier, many women who suffer from heart valve diseases can manage their condition with medications and a healthy lifestyle.

In the future you may need surgical treatment if your valve deteriorates.

It is important to discuss with your doctor and healthcare team what to expect-long term.

If you are diagnosed with a heart valve disease, we recommend speaking with your doctor and treating team to learn more about daily management.

Research suggests that attending a Secondary Prevention Program for managing Heart Diseases can decrease the chance of being admitted to hospital, reduce your complications as well increase survival rates.

One suggestion is cardiac rehabilitation, as these programs will teach you more about your disease, help you recover, empower you to make lifestyle changes to improve heart health as well as reduce your risk of further problems.

Click here to find your nearest cardiac rehabilitation program.

Your doctor may have recommended that you take some new medications if you have heart valve diseases.

This could be an overwhelming time for you, especially as learn all about your new medications as well as any considerations for taking them.

Apart from having a discussion with your doctor and pharmacist, NPS Medicinewise has some great information on medication management, medication disposal as well as risk factors.

They also have some great information about medications for your heart, which can be found here.

It’s not too late to start looking after your heart health.

Here are some great and easy everyday strategies you can do to look after your heart health:

  • Don’t smoke, as quitting smoking can reduce your risk by 50% in one year. Quitline would be a great way to start your quitting smoking journey.
  • Stay active, 30 minutes per day of exercise, such as walking, can reduce your risk by 30% and delivers many positive health benefits. More information about exercise as well as a sample walking session can be found here.
  • Get some sleep, aim for 7-8 hours sleep and aim to try and unplug from your technology (e.g. iPad) one hour before bedtime. The Sleep Health Foundation has many great women’s focused sleep pages for all stages of your life such as your menstrual cycle, pregnancy, new mothers and menopause.
  • Eat healthy: ensure you watch portion sizes, eat healthy and nourishing foods such as: high fibre foods (including oats and legumes), two pieces of fruit and seven serves of vegetables, reduced salt, three serves of fish per week, reducing saturated fats (such as chicken with skin on, baked goods, fried foods) whilst choosing more lean proteins such as tofu and trimmed meats. The Baker Heart and Diabetes Institute has created some handy factsheets to help you choose correct portions, supermarket shopping, healthy snacks and eating out.
  • Relax: try and take some time out for yourself, keep connected with friends and family, perhaps try activities such as meditation to help manage your stress levels. Beyond Blue has a great page full of practical stress relieving tips, and it could be worth to try some meditations from apps such as Smiling Mind, Headspace and Calm.

If you need Heart Valve surgery, we recommend discussion your treatment options, expectations and recovery with your surgeon and your family.

Most people will notice they are feeling recovered between 4-8 weeks after surgery, a process which will be helped by attending appointments for cardiac rehabilitation.

You may notice a few changes to your body after Heart Valve Surgery. These may include taste in food taste changes, experiencing a metallic taste sensation (both of which tend to dissipate after three months) as well as changes in your medication regime.

This page from St Vincent’s Hospital has useful information on life after Heart Valve surgery.