Are defective heart valves hereditary
Valvular heart disease
Heart valve defects often go undetected for a long time. Often they arise slowly through natural wear and tear. But young patients can also be affected - for example as a result of a bacterial disease or after one Heart attack . Heart valve defects should definitely be taken seriously and treated to prevent further damage to the heart.
Which heart valves are there?
Our heart is about the size of a fist and sits under our breastbone. In the resting state it beats about 60 times per minute and pumps around 5,000 liters of blood through our body every day - with exercise it can even be 10,000 liters and more.
It consists of four chambers of the heart - two antechambers and two main chambers. Their entrances and exits are each provided with heart valves, which ensure that the blood can only flow in the direction of flow. The valve at the cardiac outlet to the great body circulation is that Aortic valve . At the exit in the direction of the lungs is the Pulmonary valve and between the atria and the main chambers there are those on the left Mitral valve and on the right the Tricuspid valve .
Which heart valve diseases can occur?
In principle, any heart valve can become ill. The most common heart valve defects, however, are aortic valve stenosis and the Mitral regurgitation . The Aortic stenosis is one of the most common heart valve defects in the western world and occurs especially at an advanced age. Other heart valve defects are:
- Aortic valve insufficiency
- Mitral valve stenosis
- Mitral valve prolapse
- Pulomonal valve stenosis or insufficiency
- Tricuspid valve stenosis or regurgitation
Heart valve stenosis or - insufficiency - what is the difference?
Heart valve defects can be divided into stenoses and insufficiencies. With heart valve stenosis, deposits or scarring lead to a narrowing. This means that the blood can no longer flow out unhindered and the heart has to pump against this constriction. Valve insufficiency is when it no longer closes sufficiently and the blood can flow back.
What are the causes of a heart valve defect?
In rare cases, heart valve defects are congenital. A very small part is even discovered in the womb. The extent to which these defects are genetically determined or arise during embryonic development has not yet been clearly scientifically clarified. Some congenital heart defects are not noticed immediately after birth, but only in later years. This often happens by chance as part of a routine examination or when the first symptoms appear.
Most heart valve defects, however, develop in the course of life and have other causes. These are:
- Age-related calcification of the heart valves
- Expansion of the heart chambers or the main artery
- Bacterial infections and chronic inflammation
- Heart tumors
Symptoms of valvular disease
Not every dysfunction of the heart valves leads directly to specific symptoms. It can happen that defects remain undetected for a long time, sometimes up to decades, in extreme cases until the heart finally suffers serious damage. The following symptoms can indicate a heart valve defect and should be clarified by a doctor:
- Shortness of breath
- Decreasing efficiency
- Heart pain
- Fainting spells
- Water retention
- Blue lips (cyanosis)
- Weight loss
How is a heart valve defect diagnosed?
Well-trained cardiologists can in some cases become aware of defective valves from the murmur of the heart. The most common diagnostic method is the examination with a so-called Doppler ultrasound. With its help, the doctor can determine the size of the heart and its chambers, as well as the thickness of the heart walls. A judgment should be made as to whether the flaps move and close properly.
In addition, the cardiologist can graphically display the blood flow in the heart in color and with the acoustic flow noise. In this way, even complex heart valve defects can be reliably diagnosed. Also one Cardiac MRI is well suited to assess the functionality of the valves. In rare cases, a Cardiac catheter advised.
Valvular heart disease treatment & surgery
Medicines can help to improve or support the pressure conditions in the heart and the flow properties of the blood. So the heart can be relieved. However, medication cannot remedy the actual cause, the malfunction of the valve.
Only an operation can help here. Nowadays, some heart valve defects can be replaced without extensive heart surgery using a cardiac catheter or minimally invasive. Some surgical procedures for heart valve defects are briefly presented below.
- Heart valve reconstruction : Here the damaged heart valve is repaired during the operation. You can find detailed information on heart valve reconstruction here.
- Heart valve replacement : Here the damaged heart valve is replaced. Mechanical heart valves and biological heart valves are available.
- Balloon valvuloplasty : Ballovalvuloplasty is a procedure that is performed using cardiac catheters in mitral stenosis and Pulmonary stenosis can be applied. The constriction is widened by a balloon and deposits are blown away.
- Catheter-guided aortic valve replacement (TAVI) : In the catheter-guided procedure for replacing the aortic valve, either access via the groin or the apex of the heart is chosen. TAVI can be used in elderly patients for whom major heart surgery would be too risky.
- Mitraclip with mitral regurgitation : The insertion of a Mitraclip is a minimally invasive reconstructive procedure for mitral regurgitation. The Mirtalclip is brought via a catheter through the groin to the left heart in order to make the leaky mitral valve functional again.
When should a heart valve defect be operated?
Defective heart valves are operated on earlier today than later; even if they cause little or no discomfort. The aim is to avoid permanent heart damage and to extend life expectancy. Progress in the field of heart valve reconstruction and the replacement of faulty valves has advanced rapidly in recent years. And there is more and more research going on Heart valve operations minimally invasive to be able to carry out. If you are affected, seek detailed advice from a cardiologist or heart surgeon.
What should you watch out for after a heart valve operation?
Regardless of whether it is an artificial heart valve or prosthesis - strict endocarditis prophylaxis must always be observed after a heart valve operation. The scarring causes the blood to swirl in the heart. This increases the risk of bacteria becoming lodged and causing inflammation. Under certain circumstances, this can have fatal consequences for the heart. Therefore, before surgical interventions, treatments in the oral cavity (e.g. dental prophylaxis) and in the case of bacterial infections, an antibiotic must be taken as a preventive measure or promptly.
How resilient am I after the operation?
After a successful heart valve reconstruction, the patient is usually not restricted, fully resilient and can even do competitive sports. To keep it that way, however, regular ultrasound checks should be carried out.
Most patients are fully resilient even after a valve replacement. Endurance sport is often even advisable for a positive outcome, only those affected should refrain from competitive sport. How much is advisable will be determined by the attending physician. Blood-thinning medication is usually necessary for patients with an artificial valve. This is not the case after using a bioprosthesis.
Which specialists and clinics are heart valve specialists?
Anyone who needs a new heart valve wants the best medical care for themselves. This is why the patient asks himself, where can I find the best clinic for heart valve surgery?
Since this question cannot be answered objectively and a serious doctor would never claim that he is the best doctor, one can only rely on the experience of a doctor. The more heart valve operations a doctor performs, the more experienced he becomes in his specialty.
Specialists in heart valve reconstruction or heart valve replacement are therefore heart specialists who have specialized in the therapy of heart valve defects. Through her experience and many years of experience as a Cardiologist or Cardiac surgeons with a focus on the operation of heart valve defects, you are the right contact for heart valve surgery.
Heart valve diseases today, special volume of the German Heart Foundation, p. 4ff.
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