Encyclopedia of Health and Medicine

V–W
valvular heart disease The collective term for
the malformations and disorders that can affect
the valves of the HEART. Valvular heart disease may
affect any of the heart’s four valves: mitral, pulmonary,
aortic, and tricuspid. The most common
forms of valvular heart disease are
• stenosis, in which the valve does not open
completely
• regurgitation, also called incompetence or
insufficiency, in which the valve does not close
completely
• prolapse, affecting primarily the mitral valve, in
which the valve leaflets are irregularly shaped
such that they bulge when they close
POSSIBLE CAUSES OF VALVULAR HEART DISEASE
ANKYLOSING SPONDYLITIS atrial septal defect (ASD)
bicuspid aortic valve calcification
CONGENITAL ANOMALY
CORONARY ARTERY DISEASE (CAD)
ENDOCARDITIS
GRAVES’S DISEASE
HEART ATTACK
hypertrophic CARDIOMYOPATHY
MARFAN SYNDROME
MUSCULAR DYSTROPHY
PULMONARY HYPERTENSION RHEUMATIC HEART DISEASE
RHEUMATOID ARTHRITIS
SICKLE CELL DISEASE
SYSTEMIC LUPUS
ventricular septal defect
ERYTHEMATOSUS (SLE)
(VSD)
Until the 1950s, valvular heart disease was the
leading cardiovascular cause of death, and RHEU-
MATIC HEART DISEASE, a complication of streptococcal
INFECTION such as STREP THROAT, was the most
frequent cause of valvular heart disease. As ANTIBI-
OTIC MEDICATIONS became the standard of treatment
for strep throat and other infections, rheumatic
heart disease and correspondingly valvular heart
disease declined dramatically. Though rheumatic
113
heart disease still accounts for about half of valvular
heart disease, other causes include congenital
malformations and degenerative effects that
accompany aging.
Symptoms and Diagnostic Path
Many people who have valvular heart disease do
not have symptoms until damage to the heart
becomes significant, progressing to HEART FAILURE,
CARDIOMYOPATHY, and ARRHYTHMIA. When symptoms
are present, they may include
• tiredness or fatigue
• shortness of breath, especially with exertion
• periods of lightheadedness
• chest tightness or discomfort
• PALPITATIONS
Often, the underlying valve malformation
(congenital or acquired) exists for years to decades
before affecting the valve’s function to the extent
of causing symptoms. Sometimes the doctor
detects valvular heart disease before symptoms are
present, commonly by hearing a HEART MURMUR
during a ROUTINE MEDICAL EXAMINATION. Though
many heart murmurs are occasional and innocent
(not indicating any disease), certain valve disorders
produce distinctive murmurs. Other procedures
likely along the diagnostic path include
ELECTROCARDIOGRAM (ECG), ECHOCARDIOGRAM, and
COMPUTED TOMOGRAPHY (CT) SCAN or MAGNETIC RESO-
NANCE IMAGING (MRI). Depending on the person’s
general cardiovascular status, the cardiologist may
also recommend CARDIAC CATHETERIZATION.
Treatment Options and Outlook
Medications can control much valvular heart disease.
Those commonly prescribed include antico-