1 Heart Valve Disease

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5 Valvular heart disease Valves make sure blood flows in a forward direction –no backward leakage Tricuspid and mitral valves Pulmonic and aortic valves

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7 Valvular Stenosis Opening is smaller than normal Heart may have to work very hard Conditions –tricuspid stenosis –pulmonic stenosis –mitral stenosis –aortic stenosis

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9 Valvular Insufficiency Same as regurgitation –Incompetence –Leaky valve Conditions –tricuspid regurgitation –pulmonary regurgitation –mitral regurgitation –aortic regurgitation

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11 Causes Congenital Acquired Unknown

12 Congenital Valve Disease Wrong size Malformed leaflets (flaps) Attached incorrectly

13 Acquired Valve Disease Problems develop with valves that were once normal Changes in structure due to a variety of diseases or infections –rheumatic fever –endocarditis

14 Mitral Valve Prolapse MVP Very common –1% to 2% of the population Leaflets of mitral valve flop back into the left atrium Rarely causes symptoms Usually doesn’t require treatment

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17 Symptoms Shortness of breath Weakness or dizziness Chest discomfort Palpitations Swelling Rapid weight gain

18 Symptoms do not always relate to the seriousness of the valve disease!!

19 Murmur A swishing sound made by blood flowing through a stenotic or leaky valve

20 Tests Echocardiogram –TTE (TT = trans thoracic) –TEE (TE = trans esophageal) Cardiac catheterization Radionuclide scans MRI

21 Goals of Treatment Protect valve from further damage Lessen symptoms Repair or replace valve

22 Common Medications Diuretics (water pills) Antiarrhymthmics Vasodilators ACE inhibitors Beta blockers Anticoagulants (blood thinners)

23 Repair Percutaneous balloon valvotomy Open commisurotomy

24 Replacement Mechanical heart valve –made from plastic or metal Bioprosthetic heart valve –made from human or animal (usually pig) tissue

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26 Comparison Mechanical valve –More likely to cause clots –Must take anticoagulants –Usually for people younger than 70 Bioprosthetic valve –Does not require anticoagulants –Not as sturdy –Replace after 10 years –People older than 70

27 With either type of valve replacement, there is a risk for a heart infection (endocarditis).