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Valvular heart disease

Valvular heart disease encompasses a narrowing (stenosis), leak (regurgitation), or a combination, affecting one or more of the four heart valves (mitral, tricuspid, aortic or pulmonary). These problems can be congenital, whereby patients are born with the problem, or acquired later in life due to degeneration or infection such as rheumatic fever.

Valvular heart disease
Severe mitral regurgitation

Symptoms can include breathlessness, chest pain, palpitation, fluid overload (oedema), dizzy spells or blackouts. Diagnosis is made by performing an echocardiogram in the first instance. In some patients, further tests such as a transoesophageal echocardiogram, CT or MRI scans may be required.

Treatment of mild or moderate valvular heart disease often includes medication to help alleviate symptoms of breathlessness and oedema whilst aiming to control aggravating factors such as high blood pressure and elevated heart rates, particularly in patients with associated arrhythmia.

Severe valvular heart disease requires urgent assessment for surgical valve replacement to determine potential risks and chance of benefit, the optimal choice of heart valve (metal versus tissue) and need for blood thinners called Warfarin. Surgical treatment requires an open heart operation under general anaesthetic and, on average, a week in hospital followed by a 2-month recovery period. If patients are deemed too high risk for open heart surgery, a less invasive approach such as Transcatheter Aortic Valve Intervention (TAVI) for severe aortic valve disease, could be considered.