When every part is working, the human body is like a well-oiled machine. But when one part malfunctions, the whole machine can start to fall apart.
The heart has one of the most important functions in the machine -- pumping blood throughout the body. This process is called circulation.
Without healthy circulation, your body is like a car running out of gas. If the brain does not get enough oxygen from the blood, you might have difficulty thinking or remembering -- and if blood flow to the brain is completely blocked, you could have a stroke.
There are many different types of heart disease, and one of the most common is heart valve disease.
Fortunately, valve disease is treatable -- as long as it's found early.
Steven Weiss, MD, Physician and Chief of Cardiac Surgery at Chester County Hospital, explains the basics of heart valve disease.
First Things First: The Anatomy of the Heart (in a Nutshell)
In order to understand heart valve disease, it's important to have a basic idea of the parts of the heart.
The heart has four chambers: The two small chambers at the top of the heart are called atria. The larger chambers at the lower part are called ventricles. The bottom ventricles have valves with flaps that work like swinging doors, opening and closing to allow blood flow throughout the heart and the rest of the body.
There are four valves: tricuspid, pulmonary, mitral and aortic. When blood enters the heart, it goes to the right atrium.
- The tricuspid valve closes off the atrium and then opens up to allow blood to flow downward, into the right ventricle.
- The pulmonary valve closes off the right ventricle and then opens to release blood to the lungs. There, the blood receives oxygen.
- The newly oxygenated blood re-enters the heart into the left atrium. The mitral valve closes the atrium, collecting the blood. It then opens so blood can flow down to the left ventricle.
- Finally, the aortic valve closes off the left ventricle and opens to allow the oxygenated blood to flow out to the rest of the body.
Unfortunately, valve disease can be sneaky -- it gets worse over time and is often mistaken for something else. For example, some patients who also have a lung condition may believe that is the reason for their worsening shortness of breath. However, it might also be a sign of valve disease.
Physicians can often detect valve disease during a routine check-up if they notice a heart murmur. But not all murmurs are from valve disease, and not all valve disease has an obvious murmur.
According to Dr. Weiss, the best way to find valve disease is through an echocardiogram. This is a safe, painless test that takes moving pictures of the heart.
Your physician will let you know if he or she wants you to have an echocardiogram. "Undiagnosed valve disease keeps us up at night," says Dr. Weiss. "That's why at Chester County Hospital, we are pioneering sophisticated statistical techniques to help you and your physician determine if you need an echocardiogram."
There Is More than One Type of Valve Disease
Heart valve disease occurs when the valves stop working correctly. There are a few ways in which this can happen:
- Regurgitation: Blood leaks backward through a valve, flowing in the wrong direction.
- Stenosis: A valve narrows, causing the valve to not open enough and blocks blood flow.
- Valve prolapse: This type of disease only affects the mitral valve. It occurs when the flaps are too weak and cannot close tightly, causing regurgitation.
Dr. Weiss says that the most common problems treated at Chester County Hospital are regurgitation of the mitral valve and stenosis of the aortic valve. However, problems with any of the four valves can be treated.
Heart Valve Disease Does Not Always Require Surgery -- or Even Any Treatment, at All
You likely won't need surgery unless you have severe valve disease -- and even if it is severe, you still might not need surgery. In fact, the vast majority of valve disease patients can manage their condition without an operation.
"We often use a 'wait and see' type approach," says Dr. Weiss. "If there are no symptoms, and there is no damage to the heart muscle, we might not need to do anything other than monitor to make sure that it doesn't get worse."
If you do start having symptoms, treatment is often needed, whether surgically or through medications.
Dr. Weiss explains, "Many patients never develop severe disease and can be treated with medications only. Some patients, even those with severe valve disease, can live safely for years -- as long as they have no symptoms. But if symptoms develop, the heart is saying it can no longer keep up with the demands of that diseased valve. And that is a critical moment to identify."
So, if you have been diagnosed with valve disease and you need treatment, what comes next?
Let's take a look at treatment options in Part 2.
Related Information from Chester County Hospital: