Ask the Expert: Managing Heart Valve Disease with Common Comorbidities
There are four valves in the heart. Blood can be pumped out of the heart and into the body through valves.
When a valve has a problem opening or closing, it causes blood to leak backward.
The four valves in the heart are affected by these conditions.
The valve lets blood into the heart. This valve can cause problems.
There can be a result of mitral valve regurgitation.
- When the valve is floppy, it will collapse backward and some blood will leak backward.
- The mitral valve is aging.
- During a heart attack, the sub-valvular structures that control the opening and closing of the valve can be damaged.
- The heart valve is at risk of being infections.
rheumatic heart disease is a cause of mitral valve stenosis, which can be caused by a strep throat.
The valve opens to let blood out of the heart.
Aortic valve stenosis can occur.
- The valve is aging.
- The valve surface has calcium deposits that prevent it from opening.
- A bicuspid aortic valve is a congenital condition in which an individual is born with two leaflets in the valve instead of three, which can cause problems with opening and closing the valve.
Aortic valve regurgitation can occur when the aorta becomes dilated or stretched, which can open the valve leaflets.
Tricuspid and pulmonic valves
Carcinoid heart disease can affect the valves, which are caused by chemicals.
They become regurgitant due to diseases that affect the heart or lungs.
Degenerative conditions that cause heart valve disease are acquired conditions of heart valve disease. These conditions are examples.
- A valve that is narrowed.
- Barlow has a mitral valve disease.
- fibroelastic deficiency
Acute rheumatic fever can cause a heart valve condition called rheumatic heart disease.
Carcinoid tumors can cause valve disease by releasing chemicals that can damage the heart valves.
There is a bloodstream infection that can spread to the heart. Growth of the bacterium can cause the valve to malfunction.
There are two particular disorders that can be associated with heart valve disease.
Systemic lupus erythematosus (SLE)
In SLE, valve disease can range from mitral valve prolapse to valve growths consistent with nonbacterial thrombotic sclerosing. These growths are tissue attachment to the valve that can cause a narrowing of the valve.
Antiphospholipid antibody syndrome (APLA)
APLA can help valves develop valve nodules similar to valvular growths. The mitral valve is more frequently involved than the other valves. The valve lesions are associated with a high risk of stroke.
People with an elevated level of lipoprotein are more likely to have a narrowing of the aortic valve.
People with mitral valve prolapse are also at risk of having a condition called premature ventricular contractions, which is a type of irregular heartbeat.
People who have had a heart attack with an inferior wall infarction have a higher risk of having mitral regurgitation.
regurgitant valve lesions can be developed by anyone who has had a bloodstream infection that affects the cardiovascular structures.
Lung disease is associated with right-sided valvular lesions.
Atrial fibrillation is associated with having hypertension and diabetes, so having both can mean having atrial dilation.
This depends on the type of valve disease.
Young and healthy women can be at risk of a condition called mitral valve prolapse.
Aging, high blood pressure, high cholesterol, and atrial fibrillation are some of the conditions associated with aortic stenosis.
Atrial fibrillation is associated with mitral regurgitation. The mitral valve can become leakier as the atria enlarges. It is difficult to know which came first, as the mitral regurgitation may have triggered the event.
Here are a few more common relationships.
- High blood pressure is associated with anortic regurgitation.
- COPD and pulmonary hypertension are associated with tricuspid regurgitation.
- Atrial fibrillation, high blood pressure, and PVCs are associated with mitral regurgitation.
COPD can cause changes in the way the lungs function and can also cause high blood pressure in the lungs.
The right side of the heart is the part that pumps blood to the lungs. The pulmonic and tricuspid valves are the ones that can become leaky when the pressure is high.
The best way to manage valve disease is to manage COPD so that the pressure in the lungs is low and the valves are not under stress.
If the COPD is caused by valve leakiness back into the lungs, it can affect the function of the lungs, cause fluid in the lungs, and make symptoms worse.
If necessary, taking diuretics to reduce pressure and leakiness in the heart can help with symptoms.
Diabetes can cause the heart valves to stiffen.
It can cause the heart to be stiff and cause blood vessels in the heart to be narrowed, which can lead to a condition called Atherosclerosis.
If you have a lot of plaque in the heart muscle, you can develop heart failure.
People with diabetes may be more likely to have aortic stenosis than people without diabetes.
Keeping the sugar in the blood under control is the best way to control valve disease and other cardiovascular conditions in diabetes. A good goal for most people with diabetes is a HbA1c of less than 7 percent.
People with elevated cholesterol are more likely to have a blocked blood vessel around the heart. They may be at increased risk for the inflammation of the aortic valve.
This relationship is especially pronounced in people with elevated lipoprotein, or an extreme form of high cholesterol. Aortic stenosis can be caused by valve changes.
Control of cholesterol is the best way to control the valve disease. The LDL-C should be less than 100.
The goal of the LDL-C should be less than 70 percent in those who have already had a valve disease.
It is not clear whether treatment of elevated lipoprotein can affect the progression of valve disease.
High blood pressure can cause a number of problems. Studies suggest that elevated blood pressure can cause valve disease.
This could be caused by high blood pressure, which can cause injury to valve surfaces.
The aorta can get stretched, which can cause the valve to be pulled open and cause a leak.
Control of the blood pressure is the best way to control valve disease. The American College of Cardiology and American Heart Association recommend a blood pressure target of less than 130/80 for most patients.
It’s crucial that people with a heart valve disease and a comorbidity focus on managing the comorbidity.
The progression of the valve disease can be prevented by treating the underlying condition.
In cases where the valve disease is creating the comorbidity, people should consider taking drugs, procedures, and surgeries to treat the valve disease itself.
Making healthy lifestyle choices can help reduce the progression of heart valve disease. Adherents of steps include exercising regularly, maintaining a moderate weight, limiting alcohol intake, and treating other conditions.
Dr. Payal Kohli is an ABMS board certified noninvasive cardiologist specializing in advanced echocardiography, nuclear cardiology, and women’s heart disease. Dr. Kohli has also served as a section editor for Journal of the American College of Cardiology (JACC) and assistant editor for JACC Imaging.