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Living with Cardiac Valvular Dysfunction

What Is It?

The heart is a pump that keeps the blood circulating through the body. To keep blood flowing in the right direction, there are four valves, made of flaps of tissue that open and close as the heart pumps.
 
When any of the four valves fails to function properly, it is known as cardiac valvular dysfunction. Dysfunctional valves can reduce blood flow, let blood back up or leak into areas where it shouldn't and overtax the heart muscle, leading to heart failure.

There are four valves in the heart:

  • Tricuspid valve
  • Pulmonary valve
  • Mitral valve
  • Aortic valve

One of the most common types of cardiac valvular dysfunction is mitral valve prolapse (MVP), which occurs when one of the two flaps of the mitral valve collapses backward allowing blood to back up or "regurgitate" into the heart's left atrium (upper holding chamber). One in 20 Americans has mitral valve prolapse, including a larger percentage of women than men. Often, they are born with it.

Mitral valve prolapse is also known as click-murmur syndrome, Barlow's syndrome, balloon mitral valve and floppy valve syndrome.

Diagnosis

Some people with cardiac valvular dysfunction have no symptoms at all. Sometimes the only sign of the condition is a slight heart murmur (extra beat of the heart) heard by a physician during a regular physical exam. However, when the dysfunction is more severe, it can cause a number of symptoms.

Talk to your doctor if you experience any of the following:

  • Racing heart or skipped heartbeats
  • Chest pain that comes and goes
  • Shortness of breath
  • Dizziness
  • Anxiety or panic

After listening to your heart with a stethoscope, your doctor may order one or more of the following diagnostic tests:

  • Chest x-ray - This will show if your heart is enlarged, a common result of a dysfunctional valve.
  • Echocardiography - This test produces an ultrasound image of your heart, including valve shape, opening size and action.
  • Electrocardiography (EKG or ECG) - This test involves attaching (with adhesive material) small electrodes to your arm, leg and chest to measure the rate and regularity of your heartbeat and to check for enlargement of the ventricles or atria.
  • Coronary angiography - This imaging technology allows your doctor to watch the valves in action as dye is injected into your coronary arteries through a thin flexible tube (catheter) inserted into the heart through your groin or arm.
  • Magnetic resonance imaging (MRI) - This test offers a three-dimensional picture of your heart and valves.

Treatment

People with valvular dysfunction are at an increased risk for endocarditis, a bacterial infection of the heart. Ask your doctor if you need to take preventive antibiotic treatment before having any dental work done or undergoing any medical procedure that could lead to bacteria being spread into the blood and traveling to the heart.

Other than preventive antibiotics, most people with cardiac valvular dysfunction need no treatment at all. Others may take medication to ease the symptoms. Commonly prescribed medicines include the following:

  • Digitalis - Reduces the workload on the heart and eases some symptoms.
  • Diuretics - Lowers fluid levels and eases the workload on the heart.
  • Anticoagulants - Prevents blood clots.
  • Beta blockers - Controls the heart rate and lowers blood pressure.
  • Calcium channel blockers - Affects the contraction of heart muscle tissue and lowers blood pressure.

If your symptoms are severe or your condition worsens, your physician may recommend one of the following options:

  • Balloon valvuloplasty - Similar to angioplasty, a balloon-tipped catheter is inserted through another catheter into the coronary arteries. When the balloon is inflated, it pushes back any calcium deposits along the edge of the valve, making the central area of the valve larger. The catheter and deflated balloon are then removed from the valve.
  • Surgery - A surgeon may be able to repair a dysfunctional valve by removing calcium deposits along the edge of the valve or reinforcing a valve that doesn't close properly. Valves that are damaged beyond repair are replaced with a prosthetic valve.