Heart Valve Disease

What causes it and how to live with it

Heart valve disease is generally caused by

  • congenital abnormalities
  • rheumatic fever
  • advanced age

It can be present in your

  • mitral valve
  • aortic valve

Less common, but still possible, in your

  • tricuspid valve
  • pulmonary valve

Your valves are designed to let your blood flow in only one direction through the heart. When you have heart valve disease you may have stenosis - a narrowing of the opening resulting in restriction of blood flow through the valve, or regurgitation - when the valve flaps do not close completely allowing blood to flow backward through the leaky valve, or, you may have both. In any case, the heart must work harder to maintain adequate blood flow to the body.

Sometimes, even in advanced stages, heart valve disease can be somewhat symptomless. It comes on gradually and your body adapts and compensates until it can no longer cope. Then you experience symptoms.

Although I was a formerly a runner, I NEVER liked running up hills. I could run long distances on flat ground, but I avoided hills (like the plague). I couldn't understand why other runners were enthusiastic about running up hills! After I found I had a bicuspid aortic valve, I realized why. I probably wasn't getting enough oxygen! My body was telling me not to run uphill because it just couldn't cope with it.

Note: Exercise won't improve or repair your valve but it is important (as approved by your doctor) because it will keep your body and cardiovascular system conditioned and stronger.

Living with cardiac valve disease

Currently, no medicines can "cure" heart valve disease, but lifestyle changes and medicines can often treat symptoms and delay complications for many years. Many people with diseased valves live very normal, active lives.

Some things to be aware of:

  • Take your medications as prescribed - your medications will help your heart pump blood more efficiently.
  • Get regular checkups - at least once a year. Usually this will include an echocardiogram (ultrasound of your heart). If the performance of your valve is not deteriorating or causing damage to your heart muscle, your doctor may choose to monitor you on a regular basis as opposed to surgery.
  • Quit smoking and follow a heart healthy diet low in carbohydrates, sugars and processed foods.
  • Talk to your doctor about whether or not you need antibiotics prior to dental or surgical procedures
  • Talk to your doctor about exercise and what you can and can't do.
  • Call your doctor if your symptoms worsen or become more severe or frequent or if you are having problems with breathlessness or passing out.

Living with a valve replacement

There have been wonderful advances in the treatment of diseased heart valves though surgery in recent years.

If you have had heart valve replacement surgery here are some things you need to be aware of:

  • If you have an artificial or mechanical heart valve you will have to take powerful anticoagulants such as warfarin for the rest of your life.
  • If you take warfarin, make sure your doctor knows about any other medications, supplements, or herbs you take. Some medications and supplements can have a dangerous interaction with warfarin.
  • Tell your health care provider that you that take warfarin before you have any medical or dental procedures including vaccinations and routine dental cleanings. If you're going to have surgery, discuss what changes might be necessary at least 10 days before the procedure. Your doctor may decrease your dose of warfarin or discontinue warfarin altogether before the procedure.
  • Avoid situations that increase your risk of injury because you are at risk of heavy bleeding.
  • Consider wearing a medic alert bracelet or carrying a wallet card that identifies that you have had a valve replacement and take warfarin. This can be useful if emergency medical personnel need to know what medications you take.
  • Some foods such as garlic, licorice, cranberries or cranberry juice, canola oils, spinach, or broccoli can interact with warfarin, so talk to your doctor if you eat these foods frequently.
  • If you have an animal or human valve replacement you won't have to take anticoagulants but the "shelf life" of the valve is much shorter. You may be looking at another replacement, possibly within 10 to 15 years.
  • All replacement valves are prone to infection that may be difficult to treat with antibiotics, so you will have to talk to your doctor about precautions.
  • You should have no special limitations on exercise (in fact you may find that you have a lot more energy than you did before your valve replacement) - but to be safe, check with your doctor.

Are you living with valve disease? Tell us your story.

Here's the story of my heart valve replacement surgery.

Warning: If you are on blood thinners (clopidogrel/Plavix, warfarin/coumadin) avoid taking supplements with blood-thinning properties such as vitamin E or garlic capsules. Talk with your doctor or pharmacist before self-medicating.

Resources

Cleveland Clinic
National Heart, Lung, & Blood Institute


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