Know your heart: Heart Valve Disease, Symptoms, Treatment

As people are living longer, parts of their body such as the heart valves can develop a problem. The National Heart Valve Disease Awareness Day gives us the opportunity to know about heart valve disease, its specific risks, symptoms, detection, and treatment, hoping to save and improve quality of life in people.

Each heart valve has two important functions: (1) to open fully so that blood can move forward, (2) to close tightly so that blood cannot leak backward. This way blood can only flow in one direction through the heart as in normal circulation. Each human heart has four valves. Tricuspid and Pulmonary valves are present in the right side of heart, which delivers blood to the lungs for oxygen enrichment. Mitral and Aortic valves are in the Left side of heart, which delivers oxygenated blood to rest of the body.

Symptoms of heart valve disease can range from none to experiencing breathlessness and chest pain which are often related to exertion, abnormal heart beats, light-headedness, fainting, swollen feet and extremities, tiredness, and inability to maintain ordinary activity.

Risk factors for heart valve disease include increasing age, a history of having sore throat and scarlet fever caused by Group A Streptococcus bacterial infection (Rheumatic Fever), infection causing damage to heart valves (Infective Endocarditis), Heart Attack, Heart Failure, Heart Rhythm disease (Arrhythmia), born with a heart defect (Congenital Heart disease), and childhood cancer survivors who had received radiotherapy treatment to the chest area.

The simplest way to diagnose heart valve disease is to visit your doctor, let your doctor examine you, including a good listen to your heart with a stethoscope. The presence of a heart murmur raises the possibility, although this may not turn out to be so. Having heard the murmur, the doctor/heart specialist can look for other clues and physical signs to establish its significance and severity. After physical examination, the doctor may order an Echocardiogram. This is a simple heart ultrasound scan in the heart area which is effective in diagnosing heart valve disease.

Treatment for heart valve disease can be divided into: (1) general healthy life style changes; (2) medicines to control high blood pressure (Hypertension), cholesterol problem, heart rhythm disturbance, heart artery disease (Coronary Artery Disease), heart failure, blood thinning for clots; and (3) surgery.

Surgical treatment options can be broadly divided into: (1) keyhole surgery through a heart catheter which is inserted through a blood vessel, (2) open heart surgery, or less invasive surgery to repair or replace one or more valves. When surgery is required, talk to your cardiologist and cardiac surgeon about which option is best for you, as this depends on a number of personal factors such as young age, ability to take blood thinning medicine, and risk of surgery,

Worsening of heart valve disease can lead to disability and development of heart failure, stroke, blood clots, and sudden cardiac death.

All people with known heart valve disease need monitoring and most may not require surgery. Surgery is required for those who have severe symptoms or serious disease. People with known heart valve disease or valve surgery require regular visits with their heart specialists.

So, next time when you notice yourself, family or friends having any of the above symptoms, encourage them to visit their doctor.

Dr Wong Sze Chai Peter is a practising cardiologist, who is accredited in imaging with Echocardiography and Cardiac Computed Tomography.

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