Non-Rheumatic Valvular Heart Disease

Symptoms


Symptoms vary depending on the severity and which valve(s) are affected. Common symptoms include:

Shortness of breath, especially with exertion or when lying down

Fatigue

Chest pain or discomfort (angina)

Dizziness or fainting

Swelling in the ankles, feet, or abdomen (edema)

Heart murmur (an abnormal sound heard through a stethoscope)

Irregular heartbeat (arrhythmia)

Rapid weight gain

Causes


Non-rheumatic valvular heart disease can arise from several causes, including:

Congenital heart defects: Valve abnormalities present at birth.

Age-related degeneration: Valves can thicken and stiffen with age (degenerative valve disease).

Infective endocarditis: Infection of the heart valves.

Myocardial infarction (Heart Attack): Damage to the heart muscle can affect valve function.

Calcification: Calcium buildup on the valves, leading to stiffening.

Other conditions: Connective tissue disorders (e.g., Marfan syndrome), radiation therapy to the chest, certain medications, or other underlying medical conditions.

Medicine Used


Medications are used to manage symptoms and prevent complications. Common medications include:

Diuretics: To reduce fluid buildup.

Beta-blockers or calcium channel blockers: To control heart rate and blood pressure.

ACE inhibitors or ARBs: To lower blood pressure and reduce the heart's workload.

Anticoagulants (e.g., warfarin): To prevent blood clots, especially in patients with atrial fibrillation or mechanical heart valves.

Antiarrhythmics: To treat irregular heartbeats.

Antibiotics: Used before certain procedures (e.g., dental work) to prevent infective endocarditis in high-risk individuals. Note: Valve repair or replacement surgery is often necessary for severe cases.

Precautions


Precautions depend on the severity of the condition. General recommendations include:

Regular medical checkups: To monitor the valve disease and adjust treatment as needed.

Maintain a healthy lifestyle: Including a heart-healthy diet, regular exercise (as tolerated), and avoiding smoking.

Good dental hygiene: To prevent infective endocarditis.

Prophylactic antibiotics: May be needed before certain medical or dental procedures if at high risk for infective endocarditis.

Manage underlying conditions: Such as high blood pressure, high cholesterol, or diabetes.

Inform healthcare providers: About the valve disease before any medical or dental procedure.

How long does an outbreak last?


Non-rheumatic valvular heart disease is not an "outbreak" type of disease. It's a chronic condition that either develops over time or is present from birth. There isn't a defined "outbreak" period. The condition may gradually worsen over years or decades. Infective Endocarditis however, can be considered to have an outbreak that can last from days to weeks depending on diagnosis and treatments

How is it diagnosed?


Diagnosis typically involves:

Physical exam: Listening for heart murmurs.

Echocardiogram: Ultrasound of the heart to assess valve structure and function.

Electrocardiogram (ECG or EKG): To check heart rhythm.

Chest X-ray: To look for signs of heart enlargement or fluid in the lungs.

Cardiac catheterization: In some cases, to directly measure pressures within the heart chambers and assess valve function.

Cardiac MRI or CT scan: To provide detailed images of the heart.

Timeline of Symptoms


The timeline of symptoms varies greatly.

Congenital Valve Disease: Symptoms might be present from birth or develop in childhood. In mild cases, it can go unnoticed until adulthood.

Age-Related Degeneration: Symptoms often develop gradually over many years. Mild valve disease may be asymptomatic for a long time.

Infective Endocarditis: Symptoms develop rapidly (days to weeks)

Progression: Once significant valve damage is present, symptoms tend to worsen over time if left untreated.

Important Considerations


Early detection and management: Can help prevent or delay complications.

Individualized treatment plans: Are essential, as the best approach depends on the specific valve affected, the severity of the disease, and the patient's overall health.

Valve repair versus replacement: The choice between repair and replacement depends on the valve involved and the nature of the damage. Repair is generally preferred when possible.

Lifelong monitoring: Is often necessary, even after valve repair or replacement.

Pregnancy: Women with valvular heart disease require careful monitoring during pregnancy due to the increased strain on the heart.