What are Valvular Heart Defects

Author Ольга Кияница


Among all diseases of the heart a special place is occupied by valvular defects, still known as valve stenosis, valve failure, valve prolapse. A large number of people around the world and at different ages are determined by heart defects. In some cases, they are not worrisome, and in others, urgent surgical intervention is required.

Valvular flaps occur when one or more valves in the heart are not working properly.Usually the valve device helps to control the flow of blood through the chambers of the heart. In case of heart valve disease, the valve opening is not fully closed or it may not open properly. This affects the blood flow and in severe cases the heart begins to work more intensively, which leads to its wear (heart failure).

Video: Boris Todurov about heart valve defects | Issue 5

What is heart valve disease?

The heart has four valves: mitral, aortic, tricuspid and pulmonary. Each of them is located at the exit from one of the four chambers of the heart. Normally, when during the contraction of the heart, blood is pushed through its chambers, the valves closing under blood pressure prevent it from flowing back.

Sometimes the valve may not open properly. This condition is called valve stenosis . Stenosis may occur because the valve opening is too small or because the valve components that open (called valves) become stiff or splice together.With valvular stenosis, the heart must work hard to push through the narrow aperture the required volume of blood from the atria to the ventricles or from the ventricles into the large blood vessels.

With valve failure, the valve does not fully close. Sometimes the valve protrudes back into the previous chamber of the heart (the so-called valve prolapse). When it does not completely close, the blood in more or less quantity is returned back to the previous chamber. Valvular failure, like valvular stenosis, causes the heart to work with redoubled force.

In the absence of treatment, valvular defects can lead to other health problems and, in particular, to the heart. Often observed their complication of arrhythmias, stroke, pulmonary hypertension or heart failure.



Among the US population, the prevalence of moderate and severe valve defects, determined by echocardiography, is estimated at 2.5%. In another group of studies based on clinical signs and symptoms, and also confirmed by echocardiographic visualization, the estimated prevalence of at least moderate valve diseases was estimated at 1.8%.This difference indicates the diagnosis of heart valve disease and illustrates the fact that a diagnosis based only on clinical information is not reliable.

Prevalence did not change with sex, but increased significantly with age, from 13.2% after 75 years, vs <2% to 65 years.The predominance of degenerative etiology explains the higher prevalence of pathology among the elderly. It is assumed that the frequency of degenerative valvular diseases will increase with the aging of the population in Western countries.

It was found that mitral regurgitation is the most frequent disease of the valves, with a prevalence of 1.7% compared to aortic regurgitation (0.5%), aortic stenosis (0.4%) and mitral stenosis (0.1%).

The average age of patients who were examined in the heart of hospitals in Europe was 65 years. It has also been found that aortic stenosis is the most frequent valve disease in patients with prescribed treatment. In 22% of all patients, the main cause was rheumatic heart disease.

In developing countries, approximately 30 million cases of rheumatic fever occur annually, usually in the under-20 age group. Approximately 60% of patients develop rheumatic heart disease, which becomes clinically evident after one to three decades. Rheumatic heart disease remains the most common cause of heart valve disease in third world countries. In Western countries, this pathology is the second cause of heart valve failure.


Over the past 60 years, the etiology of most valvular heart disease in industrialized countries has shifted towards degenerative pathologies, mainly due to the reduction of acute rheumatism.

Sometimes valvular defects are defined as congenital - that is, a person is born with a certain disease. Some cases of heart valve pathology are caused by their physiological deterioration (aging), since they open and close hundreds of thousands of times a day throughout the life of a person. Other cardiac diseases or disorders can contribute to heart valve disease, causing their scarring or thickening. Most often, to valve defects leads:

  • Cardiac ischemia
  • High blood pressure
  • Previously endured heart attack
  • Cardiomyopathy

Some infectious diseases can also cause valvular flaws by scarring and damaging the valve flaps. In particular, rheumatic fever leads to a similar pathology, which was very common before the widespread use of antibiotics. Another such disease is endocarditis, that is, an infectious lesion of the inner layer of the heart. Once the valves have been damaged once by endocarditis, they are more prone to re-infection.


Sometimes heart valve disease does not cause any unpleasant symptoms. In such cases, the only manifestation may be cardiac noise, which can be heard through a stethoscope.

Symptoms of valvular heart disease may include:

  • Shortness of breath, especially during exercise or lying down
  • Dizziness or fainting
  • Chest pain or pressure feeling
  • Palpitation (feeling of heart popping out of the chest)
  • Weakness or fatigue
  • Swelling of the legs, ankles, or abdomen

Many of these symptoms can be confused with less serious conditions, the effects of aging or physical hypodynamia.Also, similar signs may occur in other diseases affecting the heart or lungs.

The severity of the symptoms does not always correlate with the severity of valvular heart disease. Some patients with minor manifestations may need immediate treatment to prevent further damage to the heart


For the definition of valvular defects, the following studies are usually used:

  • Echocardiography: to assess the structure, function of the valve and blood flow to the chambers of the heart
  • Electrocardiography: helps to identify problems with the heart rhythm
  • Radiography of the chest: allows you to determine the size and shape of the heart
  • Coronary catheterization: reveals blocked or spasmodic blood vessels
  • Stressful stress test: measures the functional capacity of the heart, when it has to work under physical stress
  • Magnetic resonance imaging (MRI): make detailed images of the chambers of the heart and blood vessels.


In many cases, the symptoms of valvular malformations can be controlled with medication, but in the end, surgical repair or replacement of the affected valves will often be required. There are many options for treating any type of valvular malformations. Only a trained specialist can determine the appropriate method for each case separately.


Many medications are needed to reduce the symptoms of heart valve disease. Depending on the indications, appropriate means can be assigned:

  • Reduced blood pressure - ACE inhibitors or angiotensin receptor blockers
  • Slow heartbeat (bradycardia) - beta blockers
  • Rapid heart rate (tachycardia) or extrasystole - antiarrhythmic drugs
  • Prevention of thrombus formation in blood vessels - anticoagulants and blood thinners
  • Removal of excess fluid from the body - diuretics


Valvular defects often require the reconstruction or replacement of a faulty valve, which otherwise could damage the rest of the heart. If reconstruction is possible, then it is preferable to replacement, because the repaired valve is more adapted to the characteristics of a particular person than an artificial counterpart.

Catheter procedures

These manipulations are a minimally invasive intervention and are suitable for patients who do not have a volumetric surgical procedure.

  • MitraClip: during this procedure, the device is inserted through the catheter and attached to the mitral valve flaps, firmly securing them and allowing the valve to be better closed.


  • Transcatheter Aortic Valve Implantation (TAVI): During this manipulation, the replacement valve is inserted through the catheter and implanted inside the existing aortic valve.

Change in lifestyle

  • People with valve defects of any type can help themselves if they reduce the amount of salt in the diet, which will reduce blood pressure.
  • It is useful to control the intake of fat and cholesterol.
  • If there is excess weight, then the loss of extra pounds can help alleviate some of the symptoms of the disease, as the burden on the heart will decrease.
  • Patients with any type of heart disease that smoke should give up this addiction.
  • If it's difficult to quit smoking on your own, then there are different ways to quit smoking.

Risk factors and prevention

Some risk factors for valvular heart disease are the same as in other heart diseases. Their influence can be reduced with a change in lifestyle or early detection and treatment of the disease. To prevent heart disease in general, it is important:

  • Quit smoking and give up alcohol
  • Monitor blood pressure and cholesterol levels
  • To eat healthy food
  • Regularly train
  • Keep body weight within normal limits

Additional recommendations for preventing the development of cardiovascular diseases, including valvular defects, can be given by the doctor after a thorough examination.

Video: Heart disease

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