Heart valve disease: What is it, what are the symptoms, and how can it be treated?

As Heart Valve Disease Awareness Week comes to an end, specialists have been spreading awareness of the disease that affects more than one million Canadians.

What is heart valve disease?

Heart valve disease is common and serious but can also be treatable. It can happen in any of the heart's four valves; however, certain types are more common than others.

If one or more of the heart's valves aren't opening or closing properly, this can mean you have heart disease.

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"So, the heart is a muscle, it pumps the blood through the whole body. And what happens is, in order for that blood to go efficiently, there's four valves that makes the blood move forward," said cardiologist Dr. Osama Elkhateeb during an interview on CTV Morning Live Friday.

"And with different causes, one of the most common is as we get older, calcium builds up in those valves, they get narrowed, so the blood would have difficulty going through those valves."

What are the symptoms?

Symptoms of the disease can vary depending on which valve is affected and how badly it's damaged.

The most common symptoms of heart valve disease include:

• fatigue or reduced exercise ability
• shortness of breath or fatigue after a previously normal amount of activity
• irregular heartbeat
• dizziness
• chest pain
• fainting
• ankle swelling

Who can be affected?

Heart valve disease is usually caused by wear and tear, disease or damage.

Some of the most common risk factors include:

• Older age: Degeneration to the valves is the most common cause of valve disease.
• Congenital abnormalities: People can be born with narrow, deformed or even missing valves.
• Family history: Blood relatives who had/have valve disease could increase risk.
• Radiation to the chest and certain chemotherapy: Some types of cancer require radiation therapy to the chest that can damage the valves and cause the disease many years later.
• Other health conditions, such as chronic kidney disease, lupus and Marfan syndrome can all increase risk of the disease.

Symptoms are also not always obvious, even when valve disease is severe.

"As we all commonly know about heart attacks, they all occur suddenly. You have a chest pain or shortness of breath and you go to the hospital. With heart valve disease, it's a little bit different because it can take months, and sometimes even years for these symptoms to develop," said Elkhateeb.

"And what happens is, as we get older, we sometimes attribute these things to, 'I'm a bit out of shape,' or shortness of breath and then you get it ignored. And this is where it's really important, if you have any symptoms, is to get your doctor to check those and they will discuss how they can check that."

How is it diagnosed?

If you or a health-care professional believe you have the disease, further testing will be arranged to diagnose the severity of your condition, as well as determine the best treatment options.

Tests that could be scheduled include:

• Electrocardiogram (ECG) to measure your heart’s electrical patterns.
• Echocardiogram to get sound wave images of your heart and valves.
• Chest X-ray to look for fluid in your lungs or enlargement of your heart.
• Cardiac magnetic resonance imaging (MRI) to create detailed images of your heart.
• Exercise or stress tests to see how the valves change or symptoms develop with exertion.
• Cardiac catheterization to examine blood flow and test how well the heart and valves are functioning.

What are the treatments?

Treatments for heart valve disease ranges based on the severity and symptoms themselves, how well your heart is functioning and your overall health.

Treatment options include:

• surgical valve replacement, when the disease valve is replaced with another one
• transcatheter-based valve replacement
• surgical valve repair, which is most often used to repair the mitral valve when it is not closing properly, although, in some cases, other valves can also be repaired
• transcatheter-based valve repair
• medical management

"Not always do you need an intervention. Sometimes, a simple medication can fix that valve and some of them are curable… And I think if we get it early, the damage to the heart doesn't happen and we can prevent lots of complications," said Elkhateeb.

More information on heart valve disease can be found on Heart Valve Voice Canada's website.