Valvular disease is when there is damage to any of the four heart valves: the mitral, aortic, tricuspid or pulmonary. During valvular heart disease, the valves become too narrow and hardened (stenotic) to open fully, or are unable to close completely (incompetent).
The mitral and tricuspid valves control the flow of blood between the atria and the ventricles (the upper and lower chambers of the heart). The pulmonary valve controls the flow of blood from the heart to the lungs, and the aortic valve governs blood flow between the heart and the aorta, and thereby the blood vessels to the rest of the body. The mitral and aortic valves are the ones most frequently affected by valvular heart disease.
A stenotic valve forces blood to back up in the adjacent heart chamber, while an incompetent valve allows blood to leak back into the chamber it previously exited. To compensate for poor pumping action, the heart muscle enlarges and thickens, thereby losing elasticity and efficiency. In addition, in some cases, blood pooling in the chambers of the heart has a greater tendency to clot, increasing the risk of stroke or pulmonary embolism.
The severity of valvular heart disease varies. In mild cases there may be no symptoms, while in advanced cases, valvular heart disease may lead to congestive heart failure and other complications.
The main test for diagnosing heart valve disease is echocardiography (echo). Echocardiography is a painless test that uses sound waves to create moving pictures of the heart. These pictures show the size and shape of the heart, as well as the heart's chambers and valves. Using a type of echo called Doppler ultrasound, doctors can see how well the blood flows through the heart’s chambers and valves.
Echo can detect blood clots inside the heart, fluid buildup around the heart, and problems with the aorta, which is the main artery that carries oxygen-rich blood from your heart to the rest of your body.
An EKG (electrocardiogram) or chest x ray is also used to reveal certain signs of the valvular disease.