There are four valves within your

heart. They are the mitral,

tricuspid, aortic and pulmonic
valves. The valves make sure
blood flows in only one direction
through the heart.
What is heart valve disease?
Valvular heart disease occurs
when your heart's valves do not work
correctly. Valvular heart disease can be
caused by valvular stenosis or valvular
insufficiency.

Valvular stenosis , the tissues

forming the valve leaf lets
become stiffer, narrowing the
valve opening and reducing the
amount of blood that can flow
through it. If the narrowing is
mild, the overall functioning of
the heart may not be reduced.
However, the valve can become
so narrow (stenotic) that heart
function is reduced, and the rest
of the body may not receive
adequate blood flow.
Valvular insufficiency (or
regurgitation, incompetence,
"leaky valve"), occurs when the
leaflets do not close completely,
letting blood leak backward
across the valve. This backward
flow is referred to as regurgitant
flow.

A regurgitant (incompetent,
insufficient, or leaky) valve does not close
completely, letting blood move backward
through the valve. Some patients may
have both valvular stenosis and valvular
insufficiency in one or more valves. Valve
disease causes the heart muscle to work

harder to circulate the right amount of

blood through the body.
What causes valve disease?

Congenital

Aquired (develop a
problem later in life)

Ediopathic or unknown

in the valve structure, such as stretching

or tearing of the chordae tendineae or
papillary muscles, fibro-calcific
degeneration or diliatation of the valve
annulus. Sometimes the cause of
acquired valve disease is unknown.
Infective endocarditis and rheumatic
fever can lead to valve disease.

Congenital valve disease develops

before birth. Common problems that
cause this type of valve disease are
abnormal valve size, leaflets that are not
properly formed, and abnormal leaflet
attachment. This most often affects the
aortic or pulmonic valve.
Bicuspid aortic valve disease is a type
of congenital valve disease that affects
the aortic valve. The valve has two
leaflets (cusps) instead of three. Without
the third leaflet, the valve may be:
stenotic - stiff valve leaflets that
can not open or close properly
leaky - not able close tightly
(regurgitant).
Acquired valve disease
Acquired valve disease includes
problems that develop with valves that
were once normal. Acquired disease can
be the result of infection, such as
infective endocarditis and rheumatic
fever. It can also be caused by changes

Rheumatic fever causes a common type

of valve disease, rheumatic heart disease.
It causes following:
o the heart valve leaflets may
become inflamed
o the leaflets may stick together
and become scarred, rigid,
thickened and shortened
o one or more of the valves (most
commonly the mitral valve) may
become stenotic (narrowed) or
leaky
Rheumatic fever is usually the result of an
untreated streptococcal infection, such as
strep throat. The use of penicillin to treat
strep throat can prevent this disease.
Rheumatic fever occurs most often in
children aged five to fifteen. It sometimes
takes years for symptoms of valve
disease to develop. The valve itself is not
infected when you have rheumatic fever.
Instead, the body produces antibodies to
fight the infection, and they react with the
heart valves, causing inflammation and
eventual scarring.
Endocarditis/Infective endocarditis (also
called bacterial endocarditis) is a lifethreatening infection of the heart valves
or the heart's inner lining (endocardium).
It occurs when germs (especially
bacteria, but occasionally fungi and other

microbes) enter your blood stream and

attach to the surface of your heart valves.
With endocarditis:

germs attack the heart valve,

causing growths on the valve,
holes in the valve or scarring of
the valve tissue

may cause the valve to leak or

become stenotic (narrowed)
The germs can enter your blood
stream during:

dental procedures

surgery

intravenous (IV) drug use

severe infections

Other causes of valve disease

include:

coronary artery disease

heart attacks
cardiomyopathy (heart muscle
disease)
Syphilis
Hypertension
aortic aneurysms
connective tissue diseases
and less commonly, tumors
some types of drugs and radiation

Mitral Valve Prolapse (MVP)

Mitral valve prolapse (MVP) is a
type of myxomatous valve disease caused
by weaker than normal connective tissue
in the mitral valve. The condition causes
the leaflets of the mitral valve to flop
back into the left atrium when the heart
contracts. The tissues of the valve also

become abnormal and stretchy, causing

the valve to leak.
Is mitral valve prolapse serious?
MVP affects about 1 to 2 percent
of the population. Men and women have
the same risk of MVP. The condition
usually is not a reason for concern. Only a
small percentage of patients with MVP
eventually need surgery. If the prolapse
becomes severe or is associated with torn
chordae or flail leaflets (floppy, lacking
support), it could lead to a bad leak, and
surgery may be needed.
When the heart valves begin to fail,
the heart beats harder to make up
for the reduced blood flow. As the
heart beats harder, symptoms of
valve disease may occur including:

Shortness of breath or difficulty

catching your breath
You may notice this most when your are
active (doing your normal daily activities)
or when you lie down flat in bed. You may
need to sleep propped up on a few pillows
to breathe easier

Palpitations
Heart palpitations may feel like a rapid
heart rhythm, irregular heart beats,
skipped beats or a flip-flop feeling in your
chest.

Swelling of your ankles, feet or

abdomen
Edema is swelling of the ankles, feet or
abdomen. Swelling may also occur in your
belly, which can cause you to feel
bloated.

Weakness or dizziness
You may feel too weak to carry out your
normal daily activities. Dizziness can also

occur, and in some cases, passing out

may be a symptom.

Quick weight gain

A weight gain of two or three pounds in
one day is possible.

Discomfort in your chest

This may feel like a pressure or weight in
the chest with activity or going out in cold
air.
Tricuspid valve disease/abnormal
function of the tricuspid valve.
Two types of tricuspid disease include:
Tricuspid regurgitation - the valve
is leaky or doesn't close tight
enough, causing blood to leak
backwards across the valve
Tricuspid stenosis - the valve
leaflets are stiff and do not open
widely enough, causing a
restriction in the forward flow of
blood. Your physician may refer to
this as an increased pressure
gradient across the valve, found
by echocardiogram or cardiac
catheterization.
Tricuspid valve disease can be caused by
Infection, such as rheumatic fever
or infective endocarditis.

Republic of the Philippines

Camarines Sur Polytechnic Colleges
Nabua, Camarines Sur 4434
Graduate School

SUBMITTED BY:
ROBERT JAY B. IBARRETA
MAN1