Heart valve defects

If you have a heart valve defect, this means that one of your heart valves no longer functions correctly. If a heart valve no longer opens completely, this is called heart valve stenosis. If one of them no longer closes completely, this is called heart valve insufficiency. If both are affected, this places strain on the heart and leads to [cardiac insufficiency] or to other heart diseases over the long term. A heart valve defect often does not cause any symptoms for a long time, so it is often discovered by coincidence during a routine examination.

The human heart has four heart valves. Two on the left and two on the right side of the heart. On the left side, the mitral valve controls the blood flow between the atrium and the ventricle, while the aortic valves control the blood flow between the ventricle and the aorta (main artery). The tricuspid valve is on the right side of the heart and regulates the blood flow between the atrium and the ventricle; the pulmonary valve controls the blood flow between the ventricle and the pulmonary artery. In the event of heart valve insufficiency, the valve leaks, causing some of the blood to flow back through the valve. In the event of heart valve stenosis, the valve is constricted and the heart has to work against greater resistance because the valve can no longer open completely. Both place strain on the heart and lead to cardiac insufficiency over time. The most common heart valve diseases are mitral valve insufficiency and aortic valve stenosis.

Heart valve defects occur for various reasons. Congenital heart defects are a rather rare form which must already be treated in infancy. Heart valve inflammation during endocarditis or rheumatic fever can also cause heart valve defects. If a patient has suffered a heart attack with scar formation, they may then develop a heart valve defect. Due to the generally higher life expectancy nowadays, heart valve defects have also become more age-related, i.e. caused by ‘natural’ wear and tear on the valves.

The symptoms of heart valve disease differ, depending on the affected valve and the extent of the valve defect. Patients with a heart valve defect often do not present any symptoms for a long time, and these symptoms are only discovered unexpectedly. If cardiac insufficiency develops, symptoms such as shortness of breath, chest pain, limited fitness cardiac arrhythmias and oedema can occur. The risk of a stroke also increases because blood clots can form on the diseased valves.

Heart valve defects cause heart murmurs. An experienced doctor can recognise heart valve disease while listening to the heart. However, the most important diagnostic examination to recognise heart valve defects is an echocardiography, which is an ultrasound examination of the heart.

The treatment for a heart valve defect depends on the severity of the defect itself. Mild forms do not require immediate surgery. The course of heart valve disease is monitored with regular follow-up examinations. If there is a risk of long-term damage to the heart or if this has already happened, surgical treatment is recommended. Depending on the situation, there are different surgical treatment options available: reconstruction of the defective heart valve, use of an artificial heart valve or a heart valve made of animal tissue. Find out more in the chapter entitled Heart valve surgery.