What is it about ?
The heart is a large, hollow muscle, which is located approximately in the middle of the chest (thorax). Its function is to pump blood through the body, through the lungs for oxygen, and then out to the rest of the body to supply the organs with oxygen.
The heart consists of two parts: the left heart and the right heart. The right heart pumps blood to the lungs (small circulation) and the left heart pumps blood through the rest of the body (large circulation). Each half includes an atrium and a ventricle.
Blood reaches both halves of the heart in the atria. The heart muscle pumps blood from the atria through a valve to the ventricles, then from the ventricles through another valve to the arteries. The heart’s four valves ensure that the blood flows in the right direction and does not flow back.
The mitral valve is located between the left atrium and the left ventricle, the tricuspid valve between the right atrium and the right ventricle, the aortic valve between the left ventricle and the aorta, and the pulmonary valve between the right ventricle and the right ventricle. ‘pulmonary artery.
There are different types of heart valve disease. A valve can calcify and therefore no longer open completely. It can also become too loose and no longer close completely.
When a valve does not open or close properly, a murmur is audible as the doctor listens to the heart with a stethoscope.
The vast majority of non-congenital heart valve conditions develop with age. Just like blood vessels, valves can also calcify and stiffen.
The risk factors are high cholesterol, hypertension, smoking, overweight, … Inflammatory diseases such as rheumatism can also be a trigger.
Qhat is their frequency?
The most common non-congenital heart valve disease (40% of all heart valve disease) is narrowing of the aortic valve, or aortic stenosis. About half of people over the age of 80 have some form of aortic valve stenosis, and in 4% of cases the condition is so severe that it leads to heart failure.
Of the non-congenital heart valve conditions, the second most common condition in adults is mitral valve that no longer closes properly. This is called mitral regurgitation.
Other heart valve conditions are much less common:
- A tricuspid valve that no longer closes properly (tricuspid insufficiency)
- A mitral valve that no longer opens properly (mitral stenosis)
- An aortic valve that no longer closes properly (aortic insufficiency)
How to recognize them?
Diseases of the heart valves usually take several years to become so severe that they cause symptoms.
Narrowing of the aortic valve (aortic stenosis)
As the aortic valve opens less well, the left ventricle will try to compensate for the problem by working harder to still send as much blood as possible through the body. The heart muscle will therefore thicken.
The efforts will be much more difficult. Possible symptoms are shortness of breath and chest pain. In the advanced stages, loss of consciousness can even occur on exertion. Sudden death is rare. About a fifth of people with aortic stenosis develop an increased tendency to bleed, especially in the gastrointestinal tract.
Mitral valve that does not close properly (mitral insufficiency)
Mild to moderate forms do not cause symptoms. Because the valve no longer closes properly, a small amount of blood may flow back to the lungs when the heart contracts. This can result in pulmonary edema (“water in the lungs”). The main symptom is shortness of breath, first on exertion, then at rest. Palpitations, irregular heartbeat, and chest pain may also be present. Due to the fluid build-up, the legs may swell (edema) and the liver may dilate, resulting in an upset stomach. There is also weight gain.
How is the diagnosis made?
Often the doctor will make the diagnosis as soon as he hears the heart murmur. Its nature varies depending on the type of anomaly. The basic tests to confirm the diagnosis are an echocardiogram and an examination of the blood vessels of the heart (Doppler examination).
Echocardiography is a completely painless ultrasound that allows you to view the heart and heart valves after applying a gel to the chest. Doppler examination, on the other hand, shows blood flow in the heart and vessels.
What can you do ?
- Try to lead the healthiest and most peaceful life possible.
- Avoid sudden heavy physical exertion.
- Keep moving, within the limits imposed by the symptoms.
- Watch your weight.
- Do not smoke.
- If you feel short of breath while at rest, it may help to elevate your head and the foot of your bed slightly.
What can the doctor do?
At present, there is no treatment capable of stopping the progression of a disease of the heart valves. But the doctor will treat the consequences, such as heart failure.
In the event of serious structural abnormalities associated with symptoms and in the presence of an acceptable surgical risk, heart valve surgery will be considered. The procedure involves replacing the diseased valve with an artificial valve. If the risk of complications is too great in the event of an operation on the heart, the diseased valve can sometimes be replaced by passing through a catheter.
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