Deterioration of Heart Valves Sometimes Doesn't Give Any Symptom

The heart of a healthy person contracts about a hundred thousand times a day and continues to pump blood. The four valves of the heart are opened and closed without rest throughout the day and play an important role in the delivery of the pumped blood to the body.

Emphasizing that in some cases, the heart valves cannot be opened and closed sufficiently and various health problems are experienced because of this, Bayındır Health Group, one of the group companies of Türkiye İş Bankası, Head of Cardiovascular Surgery Department of Bayındır Söğütözü Hospital, Assoc. Dr. Yaman Zorlutuna conveyed important information about heart valve diseases and treatment methods, stating that the deterioration of the heart valves sometimes gives no symptoms and that there are people who have lived with this problem for years and are not aware of it.

The heart, which is the pump of our circulatory system, consists of four chambers and has four valves. Doors that open and close without resting all the time cause various health problems when they cannot be opened or closed adequately. There are four heart valves in our body, namely the Tricuspid Valve, Pulmonary Valve, Mitral Valve, and Aortic Valve, which open and close with each heartbeat, directing the flow of blood in the heart chambers:

The most important cause of heart valve diseases in our country is the damage to the heart caused by acute joint rheumatism in childhood or adolescence. Stating that the diseases can be congenital or due to degeneration, Assoc. Dr. Emphasizing that the damage to the heart valves, regardless of the cause, has two main consequences, Yaman Zorlutuna gave information about valve failure and valve stenosis:

• Lid Failure: Valves cannot close completely. As a result, some of the blood that should have flowed forward escapes backwards. Therefore, our heart cannot pump enough blood to our body. The heart begins to work harder to meet its needs. As a result, the load on the heart increases. If valve failure is excessive and not treated on time, it can cause heart failure.

• Cover Narrowness: The opening area of ​​the covers is narrowed. Therefore, there is a decrease in the amount of blood passing through the valve. The heart expends more power to compensate for this situation. In some cases, both stenosis and insufficiency may coexist in the same valve.

DIFFERENT SYMPTOMS ARE EXPERIENCED ACCORDING TO THE COVER WHICH IS DETAILED

Explaining that heart valve diseases cause some different problems and complaints compared to the valve with deterioration, Assoc. Dr. Yaman Zorlutuna gave information about the different symptoms experienced in different heart valves:

• Findings in the most affected mitral valve occur earlier than in the aortic valve. The most prominent complaint is dyspnea, which increases over time. In addition to this, in the following periods; palpitations, swelling in the legs, fatigue can appear as quickly.
• In the aortic valve, which is located in the outflow tract of the left ventricle and is the second most frequently infected, the findings appear at a later stage. In fact, most of the patients learn that they have aortic valve disease during their health check-ups. The most prominent symptoms of aortic valve patients are palpitations, chest pain and dizziness.
• In tricuspid valve diseases, which are less common and are usually associated with mitral valve disease, the findings may manifest as swelling in the abdomen and legs. Pulmonary valve diseases, which are the least common heart valve diseases, are generally seen as congenital heart diseases. Pulmonary valve stenosis or complete obstruction can be seen in newborn babies as a congenital anomaly. In these patients, different findings may occur depending on palpitations and other congenital heart anomalies.

'IN HEART VALVE DISEASES, IT IS THE PATIENT'S COMPLAINT THAT DIRECTS THE PHYSICIAN TO DIAGNOSIS'

The most important factor that guides the physician to the diagnosis in heart valve diseases is the patient's complaints and history. Stating that symptoms such as shortness of breath, palpitations, and fatigue are considered as important clues for heart valve diseases, Assoc. Dr. Yaman Zorlutuna: “Patients usually complain of getting tired quickly when climbing stairs, putting 2 or 3 pillows under their heads while lying down, or waking up with shortness of breath from sleep. These complaints appear as typical symptoms of mitral valve disease. In an examination, some findings that are typical for valvular diseases can be obtained.

THE ANATOMICAL STRUCTURE OF THE HEART IS INSPECTED IN ALL DETAILS WITH ECO

Assoc. Dr. Yaman Zorlutuna, however, underlined that the most important examination tool in diagnosis is the echocardiogram and continued his words as follows:

“In this method, also called ECO for short, the anatomical structure of the heart can be examined in all details with ultrasonic sound waves. If there is an anomaly that cannot be clarified by ECHO, which we can obtain very detailed information about valve pathologies, or if an additional heart disease is suspected, cardiac catheterization or angiography can also be used as a diagnostic method.”

TREATMENT OF HEART VALVE DISEASES

Assoc. Dr. Yaman Zorlutuna shared information about the treatment methods by stating that the treatment options in heart valve diseases can be examined in 3 sections as medical, that is, drug treatment, some interventional methods and surgery:

1. Medical Treatment: Although the main purpose of drug therapy is to slow down the progression of the disease and to minimize the complaints of the patients, drug therapy cannot eliminate the mechanical problem in the valve. Most of the time, medications are insufficient to prevent the progression of the valve disease. However, the negative effects of valve disease on the heart can be prevented to a large extent with medication. In the treatment of heart failure and rhythm disorders that develop on the basis of heart valve disease, drug therapy alone is often sufficient.
2. Interventional Methods: As soon as the drug treatment is insufficient or the deterioration of the valve begins to affect the heart significantly, some interventional methods can be applied as an alternative to surgery, depending on the type of deterioration in the valve.

One of the most frequently used interventional methods today is the removal of the stenosis with a balloon, which is used in mitral valve stenosis. In this method, a thin wire is entered through the veins in the groin and advanced into the heart, and sufficient opening is achieved with a balloon inflated at the level of the narrowing valve. In the selection of this method, which can be applied in mitral valve stenosis, it is important whether there is calcification or leakage in the valve. In addition, although there is a limited indication area, aortic and mitral valves can be changed with the help of a catheter inserted through the inguinal vein.

1. Surgical treatment: When surgical treatment, that is, surgery, comes to the fore, what is done is generally to repair the valve, if this is not possible, to remove the defective valve and replace it with a prosthesis, in other words, an artificial valve. Valve repair is mostly successfully applied to mitral and tricuspid valves where there is leakage and there is not much calcification in the valve structure. The heart valves of the patient, in whom this procedure cannot be performed, are replaced with prosthetic valves. Replacing the valve with a prosthetic valve before the time is up is not the right approach. It should not be forgotten that the best cover is one's own natural cover. On the other hand, delaying the operation when necessary causes permanent damage to the heart and may put the person's life at a very serious risk that cannot be avoided.