Damage to the four valves of the heart can occur as a result of defects from birth, heart disease or chronic conditions such as emphysema or high blood pressure. Valve damage comes in two forms: regurgitation and stenosis. Regurgitation occurs when the valves are unable to close fully, allowing blood to flow backward. Stenosis refers to when blood is having difficultly flowing through the valves because of damage or scarring to the valves. A damaged valve can have either or both defects. Because heart valve damage often develops slowly, symptoms often are not present or are vague, such as a general feeling of fatigue. There are a few symptoms specific to each type of damage to each valve. A doctor, however, should make the final diagnosis.
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Heart valve damage might produce no visible symptoms at all, depending on its severity. People with heart valve damage might experience chest pain or feel palpitations from an irregular heartbeat. They might feel tired or dizzy or have difficulty catching their breath. Blood pressure irregularities--both high and low blood pressure--also can signify heart disease. Migraine headaches can be a symptom of heart valve damage as well.
The mitral valve connects the atrium and ventricle on the left side of the heart. Stenosis of the mitral valve can develop from childhood cases of rheumatic fever or later in life from congenital heart disease. The condition can cause shortness of breath, aggravated when the sufferer is either lying flat or performing physical tasks. Exhaustion and palpitations also might occur. Exercise or high levels of stress will make the symptoms more severe. All these symptoms will become more pronounced if the stenosis worsens, and the heartbeat might become irregular. Mitral valve regurgitation afflicts about 20 per cent of people 55 or older, according to the Mayo Clinic, and usually is dormant for years without any symptoms. When the damage develops quickly, symptoms include shortness of breath, fatigue, a lightheaded feeling and heart palpitations or murmur. Swollen ankles and feet, frequent urination and a cough that worsens at night or while lying down also are signs of mitral valve regurgitation.
The aortic valve connects the left ventricle and the aorta, the body's largest blood vessel. Like mitral valve stenosis, aortic stenosis can develop from scarring during childhood rheumatic fever or can develop over time because of a heart defect. Chest pain, or pressure below the breast bone, is the first sign in most cases. The patient also might faint during physical exertion because of a lack of blood flow to the brain. Shortness of breath indicates a more serious case. In rare cases, the first symptom is sudden death, brought on by exercise. Aortic regurgitation, brought on by heart defects or conditions such as high blood pressure, has similar symptoms: fatigue, shortness of breath, abnormal heartbeats and chest pain. Patients also might experience fluid retention, particularly in the ankles.
The tricuspid valve connects the atrium and ventricle on the right side of the heart. Tricuspid regurgitation can develop as a result of lung diseases such as pulmonary hypertension or emphysema or from heart disorders. Besides fatigue, the only symptoms are a pulsating feeling in the neck and pain in the upper right quadrant of the abdomen, as the condition can cause an enlarged liver. Tricuspid stenosis is rare, almost always caused by rheumatic fever, and usually is not severe enough to require repair. Symptoms include palpitations, fatigue and clammy skin.
The pulmonary valve connects the right ventricle and the pulmonary artery, which carries blood from the heart to the lungs. Pulmonary regurgitation can occur as a result of endocarditis, a bacterial infection of the heart, or from pulmonary hypertension. The condition causes a fluid build-up in the legs and abdomen. It also can cause chest pain, shortness of breath, fatigue, fainting, an enlarged liver or cyanosis, a bluing of the skin. Pulmonary stenosis, usually a congenital defect, produces no symptoms in mild cases, and more severe cases might cause palpitations or shortness of breath. It also can cause swelling in the feet, ankles, abdomen or face and a decrease in urination.
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