When mentioning heart-related diseases, most people immediately think of coronary heart disease or cardiovascular heart diseases. In fact, the heart is one of the most complex organs in humans, and there are many kinds of heart diseases. If you imaging the heart is a house with a sophisticated structure, the vascular system is like the house’s water system, the heart rhythm is the house’s electrical system, and the heart valve is like the house’s doors and windows. Try to imagine the consequences of damage to the doors and windows of the house? Every valve of the human body must operate smoothly so that the blood can run smoothly. Once there is a problem, not only may there be systemic symptoms, in severe cases, it may even cause heart hypertrophy and heart enlargement, or cause heart failure and cause life threatening!
Consultant Cardiothoracic & Congenital Heart Surgeon, Dato’ Dr. Hamdan Leman from Cardiac Vascular Sentral Kuala Lumpur (CVSKL) mention there are three main types of causes the Valvular Heart Disease (Heart Valve Disease) also known as: aging – degenerative, rheumatic fever, and heart infectious (endocarditis).
Degenerative Valve Disease
Elderly people over 60 years old are prone to valve calcification, valve thickening and hardening, deformation of calcium salt deposition, etc. Such lesions generally lead to valve stenosis or incomplete atresia, causing blood backflow problems.
Rheumatic Heart Disease
Rheumatic fever (is a disease caused by streptococcal bacterial infection) at a young age can cause rheumatic heart damage, especially heart valve disease. Repeated attacks of rheumatic fever can cause heart valves to deform, causing valve stenosis or insufficiency, and then develop into rheumatic valvular heart disease. This kind of valvular heart disease often affects the mitral valve, usually causing mitral valve stenosis and regurgitation.
The endocardium and the inner layer covering the atrium and ventricle walls are infected with bacteria. As bacteria, fungi or other microorganisms multiply on the inner layer of the valve, the valve will eventually perforate, deform and damage the valve function.
Dato’ Dr. Hamdan Leman stated that when the medical system and sanitary environment in Malaysia were not ideal in the early days, the most common heart valve disease in Malaysia was rheumatic heart disease. However, with the advancement of medical and sanitary conditions, the cases happened rheumatic heart disease in urban areas have been greatly reduced, although some townships still have some cases.
Dr. John Chan: Early Treatment, Faster Recovery.
Dr. John Chan pointed out that mitral valve insufficiency is the most common cases happened. Whether it is the mitral valve or other heart valves, the goal of treatment is to improve patients’ symptoms and quality of life, increase survival rates, and reduce the risk of hospitalization.
The treatment plan for heart valve disease patient, is highly depends on the patient’s heart valve damage and cardiac function: “Patients with mild heart valve disease generally only need regular outpatient follow-up examinations and undergo heart ultrasound examinations, while patients with moderate heart valve disease may need depending on medication to relieve symptoms to reduce heart workload, together controlling blood pressure levels to prevent valve problems from getting worse. As for patients with severe heart valve disease, interventional therapy or surgery are recommended to improve the condition, including heart valve repair or mechanical valve replacement”.
According to his analysis, heart valve repair is to preserve and repair the patient’s heart valve. However, if the patient’s heart valve is excessively damaged or cannot be repaired, a prosthetic valve replacement is required to replace the patient with a mechanical valve. For damaged heart valves, biological tissue valves and mechanical valve are currently commonly used.
Biological valves are mainly taken from bovine pericardium (the inner layer of bovine heart) or bioprosthetic aortic valve. Most of our country uses biological valves made of bovine heart. Such biological valve replacement does not require anticoagulation treatment ( Blood thinning drugs), but the service life can only be maintained for 10 to 15 years, and a second operation is required when the valve is punctured. Mechanical valves are mainly made of titanium and metal, so they are more durable and can be used for life, but patient need to receive anticoagulants (blood thinners) for life. Therefore, as with all diseases, the sooner heart valve problems are detected and repaired earlier, the treatment effect will be more ideal and better.
Valve Stenosis and Valve Regurgitation are two most common heart valve problems
Our Human Heart valves include Mitral Valve, Tricuspid Valve, Aortic Valve, and Pulmonary Valve. These valves are like opening between the atrium and the ventricle, between the ventricle and the aorta. When the blood flow from the vein to the right atrium will pass through the tricuspid valve, and then from the right ventricle to the pulmonary artery, it will pass through the pulmonary valve, and the blood will return to the left atrium through the pulmonary circulation. Into the left ventricle, the mitral valve passes between the left atrium and the left ventricle, and the blood from the left ventricle is transported to the aorta and then passes through the aortic valve. Therefore, a normally functioning heart valve can prevent blood from flowing back, allowing blood to proceed smoothly along its normal route.
CVSKL Consultant Cardiothoracic Surgeon Dr. John Chan said that Valve Stenosis and Valve Regurgitation are the two most common causes of heart valve problems. Insufficiency can lead to blood reflux (in simple terms, the valve is not tightly closed and the blood flows back). Tightness may also cause the valve to fail to open, making the blood unable to flow out smoothly: “The most common valvular heart disease in urban areas today is a degenerative valve disease caused by aging. The main reason is that the heart valve is worn for a long time, or appears degenerative problems, resulting in aortic or mitral valve stenosis cause to happened leakage or reflux.”
Dato’ Dr. Hamdan Leman: Do Not Delay the Treatment When the Heart Problem is Diagnosed.
Dato’ Dr. Hamdan Leman urged the public to pay attention to the health problems of heart valves: “Heart valve diseases can be diagnosed through medical check-up and physical examinations. Doctors can listen to the patient’s heart for heart murmurs and perform heart ultrasound examinations for further diagnosis. Doctor will assess the degree of damage to the heart valve and evaluate the function of the heart, in order to formulate appropriate best treatment plans for the patient.”
Echocardiogram is a type of ultrasound examination, which uses sound waves to form an image of the heart to show how the heart works. Echocardiogram is an important examination instrument for heart examination. This examination can evaluate the structure and function of the heart, understand the size and contraction of the heart, and judge the activity of the heart valves. Color ultrasound and Doppler blood flow measurement can determine the direction and velocity of blood flow in the heart vessels, and can see whether the coronary arteries are stenosis, and can also detect whether there are heart valve defects.
5 warning signs to identify heart valve disease.
- Shortness of breath.
- Feel dizzy or weak.
- A sign of pressure or tightness in the chest.
- Palpitations or feeling the heart beating irregularly.
- Swelling of the ankles, feet or abdomen.
Mild valvular heart disease may have no obvious symptoms, but if the above symptoms occur, it is recommended to consult a cardiologist for further examination and diagnosis as soon as possible to find out the root cause of the problem and treat the symptoms as early as possible!