Heart valve disease

While in rare cases heart valve disease develops before birth (i.e. is congenital), in most cases, the disease is acquired in later life. The condition leads to too much pressure being placed on the heart, which may result in heart failure. Many patients with mild heart valve disease remain asymptomatic. As a result, mild valve defects are often found by chance, as a result of distinctive heart sounds.

What is heart valve disease?

Heart valve disease occurs when the heart's valves do not work correctly. The heart has a total of four valves that ensure that the blood only flows in one direction, i.e. from the atria to the ventricles, from where the blood is pumped out of the heart, either to the lungs or to the rest of the body.

Heart valves can be narrowed (heart valve stenosis) or they can become unable to close properly (regurgitation), and the heart muscle has to work harder to compensate for these defects. Over time, this excess strain may lead to heart failure. In a particularly high number of cases, it is the valves on the left side of the heart that are affected: the aortic valve, which is situated between the left ventricle and the aorta, and the mitral valve, which is situated between the left atrium and the left ventricle.

Heart valve disease as a proportion of all cardiac surgery cases. Source: Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, Jahresstatistik 2012 [German Society for Thoracic and Cardiovascular Surgery, Annual Statistics 2012].

What are the main symptoms?

Patients with mild valve disease often remain asymptomatic. As a result, the disease is usually only found by chance: either during a cardiac ultrasound examination, or because distinctive heart sounds are detected during auscultation with a stethoscope. Advanced valve disease produces symptoms of heart failure:

  • Shortness of breath during exercise; cough
  • Sometimes dizziness and fainting
  • Edema in the legs or feet
  • Valve disease is frequently accompanied by cardiac arrhythmias (e.g. severe palpitations).

What are possible causes?

    In rare cases, heart valve disease develops before birth, i.e. is congenital. More frequently, however, heart valve disease is seen to develop later in life, for instance as a result of: 

Diagnosis of heart valve disease

[Translate to English:]

  • Auscultation using a stethoscope: often, heart valve disease is detected as a result of distinctive heart sounds
  • Cardiac ultrasound scan (echocardiogram) to assess the type and extent of heart valve disease present
  • Cardiac catheterization can provide detailed information on the type of problem affecting valve function, thus assisting with treatment planning.
  • ECG for the assessment of cardiac arrhythmias

Treatment for heart valve disease

  • Medication
  • Catheter-based procedures
  • Surgical procedures
Medication

Less severe cases of heart valve disease can be treated with medication. This approach is particularly suited to managing heart failure  and cardiac arrhythmias.

Catheter-based procedures

Certain severe cases of heart valve disease can be treated using catheter-based procedures to repair the heart valves. This type of procedure involves a physician inserting a special catheter via an artery in the groin, and then advancing it all the way to the heart. The procedure then allows the physician to either widen a narrowed aortic valve (aortic valve stenosis), or to replace it with an expandable prosthetic valve. In patients with mitral regurgitation, whose mitral valves no longer close properly, the physician can use a special metal clip to hold together the mitral valve leaflets, thus significantly reducing mitral regurgitation.

Surgical procedures

Many patients with heart valve disease require surgery. An experienced surgeon can sometimes repair a diseased valve using reconstruction techniques. In many cases, however, the valve will need to be replaced with either a mechanical or a tissue valve.

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Relevant information

Emergency numbers

  • Emergencies only:
    112
    Our Emergency Department:
    +49 3338-69 45 21

Contact person

  • Univ.-Prof. Dr. med.
    Johannes Albes
    Head of Department of Cardiac Surgery at Brandenburg Heart Center

    PA to the Head of Department Gudrun Gaal
    Immanuel Hospital Bernau Brandenburg Heart Center
    Ladeburger Str. 17
    16321 Bernau bei Berlin
    T +40 3338 694-510
    F +49 3338 694-544
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