The human body has four heart valves that act like valves. They ensure that the heart pumps and the blood flows in one direction:
Four heart valves control the blood flowin the heartFourheart valves control the blood flow in the heart
If the valves are narrowed (stenosis) or do not close properly, this results in impaired blood flow. The heart can usually compensate for the deficits for a while. However, the strain ultimately leads to serious illness or even sudden cardiac death.
In Europe, experts most frequently diagnose aortic valve stenosis. This usually occurs in people over the age of 70 due to calcification of the aortic valve (atherosclerosis).
This is immediately followed by mitral valve prolapse, in which the valve of the same name bulges during contraction of the heart. The consequence of this disease is mitral valve insufficiency.
Only a small proportion of heart valve defects are congenital. In most cases, disease-related causes or life circumstances are responsible for the condition.
In many cases, the left side of the heart with the aortic and mitral valves is affected. Changes to the valves in the right side of the heart (tricuspid and pulmonary valves) are less common.
Calcification often triggers stenosis of the aortic valve.
The reasons for this are
Mitral valve stenosis, on the other hand, is usually the result of a past streptococcal infection or rheumatic fever. In rare cases, heart valve stenosis can also be caused by bacterial inflammation of the inner lining of the heart (bacterial endocarditis).
Heart valve insufficiency is often caused by a heart attack in which the heart muscle and the function of the valves are weakened.
In addition, an infection of the heart muscle (caused by viruses or bacteria) can lead to enlargement of the heart. The result is a leaky heart valve.
Patients with heart valve defects are usually spared symptoms for a long time. Only when the heart is severely weakened do the first symptoms appear. These vary depending on the malfunction.
Typical symptoms of left heart valve defects are
Blood clots can form in the heart cavities dilated by the back pressure, which can lead to a stroke.
In right-sided heart valve defects, water retention in the area of the liver and ankles is particularly noticeable. There is also rapid fatigue and shortness of breath during physical exertion.
In aortic valve stenosis, the area between the left ventricle and the aorta is affected. Usually due to calcification, the heart cannot pump enough blood through the body. The heart muscle is overloaded and thickened.
Once the flow rate has been reduced to around 25 percent of the normal blood volume , the first symptoms appear: a tight feeling in the chest, accompanied by pain (angina pectoris), shortness of breath during physical activity, dizziness or fatigue.
The mitral valve is located between the left atrium and the left ventricle. If the valve is narrowed, the heart cannot pump sufficiently. As a result, the blood backs up into the lungs. The symptoms of mitral valve stenosis are shortness of breath during physical exertion, but also when lying flat and coughing at night.
The reddened cheeks and bluish shimmering lips are particularly noticeable . Cardiac arrhythmia in the form of a racing heart or irregular heartbeat can be expected due to the overstretching of the left atrium. Later, permanent atrial fibrillation may occur.
If the mitral valve between the left atrium and the left ventricle becomes leaky, the blood backs up. The result is an expansion of the heart cavity. Patients report severe palpitations (preferably in the left-sided position). Other symptoms include shortness of breath and nocturnal coughing fits due to the blood backing up into the lungs.
Aortic valve insufficiency is often the result of a long-standing illness, but can also occur immediately after the infection.
Typical indications are
A doctor usually discovers symptom-free heart valve defects by chance when listening or as part of a check-up. If symptoms have already occurred, the doctor can become aware of a heart valve defect by describing the patient's medical history. The resting and/or exercise ECG provides initial information about the condition of the heart.
The ECG provides information about the health of the heart. Volker Werner / Fotolia
The final diagnosis is provided by echocardiography. The ultrasound not only shows the type of heart valve defect, but also its extent. In the case of stenosis, the degree of calcification, the pressure gradient and the valve opening area can also be defined.
In the case of heart failure, ultrasound provides information about the severity of the leakage. The size and function of the affected heart chamber can also be seen. This information provides the doctor with important information for the future course of treatment.
Even more precise information is provided by transesophageal echocardiography, colloquially known as swallow echo. The ultrasound examination is not performed from the outside, but from the inside. Doctors push a thin tube through the esophagus close to the heart. This shows clear images of the heart valves.
Cardiac catheterization is an important examination, especially if an operation is planned .
It provides information about
Cardiac catheterization can be used to examine valve defects. © psdesign1 / Fotolia
Heart valve defects require an operation as part of heart surgery. However, this does not always have to take place immediately. If the symptoms are only minor or non-existent, the surgical procedure may be performed later. Regular examinations by a cardiologist are important in order to detect serious deterioration.
Medication cannot correct a heart valve defect. However, some medicines are available to alleviate the symptoms:
If a heart valve defect remains untreated, it inevitably leads to fatal heart failure. As part of a surgical procedure, doctors repair or replace the valve with a new one.
Experts often reconstruct the heart valve in the case of minor mitral valve defects. The operation can be minimally invasive, which results in a faster recovery. The aim of the operation is to restore the damaged valve.
The patient usually has to have the damaged heart valve removed and replaced with a prosthesis (heart valve replacement). This can be a mechanical or a biological heart valve:
The mechanical heart valve is made of plastic and is therefore durable. This is why doctors like to use them in younger patients.
The disadvantage of this valve is the increased risk of blood clots forming. To prevent this, anticoagulant medication is taken for the rest of the patient's life.
The biological heart valve comes from the meninges or pericardium of pigs, cattle, calves or horses. Unlike the long-lasting plastic valves, these only have a shelf life of up to 15 years. They are therefore often used in older patients. Medication for blood clotting is only necessary for the first few months after the operation. Unlike a mechanical heart valve, no clicking noises are heard when the heart beats.
The chances of success with heart valve surgery are good. For the majority of patients, the quality of life improves significantly after the surgical procedure.
Nevertheless, the operation also harbors risks. Complications can occur after the procedure, especially in the case of severe heart failure:
Patients should have regular check-ups with their cardiologist after heart valve surgery and maintain a healthy lifestyle. Even with an artificial heart valve, regular exercise and gentle endurance sports are important.
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