Diagnosing A Leaky Heart Valve
A leaky heart valve must be diagnosed by a doctor who will listen to the heart through a stethoscope. The doctor will be looking for any abnormal sounds , says WebMD. The next step would be to examine the heart through a special type of ultrasound known as an echocardiogram.
Of course, the diagnostic process also includes a consultation with the doctor for the patient to explain his/her symptoms. They will also receive a physical exam. All of these steps will help determine whether or not the patient has a leaky heart valve and how serious it is.
The Causes Of Leaky Heart Valve
The following are the causes of a leaky heart valve:
- Hypertension or high blood pressure.
- Enlargement of heart due to coronary artery disease, hypertension, and other underlying causes.
- Improper closing of the valve known as mitral valve prolapse.
A few patients suffering from leaky mitral valve do not require any treatment. The doctors place such patients under observation and monitor with the help of the screening tests. Depending on the symptoms and situation, the patient can receive a surgery that will bring significant improvement in the performance. However, as the regurgitation is slow in such a case, it is difficult for the surgeon to determine when to operate.
Leaky Heart Valve And Tricuspid Regurgitation
Many healthy adults have a slightly leaky tricuspid valve. This may be discovered incidentally, usually causes no problems, and does not require treatment or follow-up.
Moderate or severe tricuspid regurgitation may result from pulmonary hypertension. Pulmonary hypertension is high blood pressure in the pulmonary artery. This high blood pressure has many possible causes. The main one is congestive heart failure.
Medicines may not be effective in treating tricuspid regurgitation. Diuretics, or water pills, can help relieve body swelling, or edema, thatâs due to congestive heart failure. The swelling is not always present, however.
The tricuspid valve may be repaired during surgery to correct other leaky heart valves. Surgical repair of the tricuspid valve generally works better than replacing it. Surgery to replace the tricuspid valve by itself is only recommended in rare cases.
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Symptoms Heart Measurements Guide The Need For Mitral Valve Surgery
The heart is a marvel of biological engineering. Four strategically placed valves ensure that every contraction propels blood forward with little or no backflow. On the right side of the heart, the tricuspid and pulmonary valves direct the orderly flow of blood on the left side, the mitral and aortic valves. Although all four valves are essential for good health, we focus on the mitral valve and mitral valve regurgitation in this article.
If the mitral valve is damaged or becomes misaligned, it can’t close completely with each heartbeat. Some blood spurts backward with each contraction. This backflow, called mitral regurgitation, puts a strain on the heart. It can provoke symptoms such as breathlessness and fatigue and lead to atrial fibrillation or heart failure.
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What Is The Treatment For A Bicuspid Aortic Valve
Depending on the severity of your bicuspid aortic valve, treatment options range from regular appointments with your cardiologist to valve repair or replacement surgery.
If there are no symptoms, doctors may monitor your heart periodically with echocardiograms. Theyll look for changes in valve function or signs that the heart is having to work harder.
You should discuss with your doctor whether you need antibiotics before any dental procedures. Some doctors recommend antibiotics for people at risk of developing endocarditis from an infection.
Although the American Heart Associations guidelines no longer include a bicuspid aortic valve as a major risk factor, there are some cases where your doctor may still recommend antibiotics.
When symptoms are present, you may need to replace or repair the valve. In some cases, doctors perform these procedures as open heart surgery. For others, the procedure can be done with a catheter inserted into a blood vessel in the leg and guided up to the heart.
If aortic stenosis has developed, the valve may have to be replaced. The replacement will be a tricuspid valve, either mechanical or made from valve tissue harvested from a cow or pig.
Doctors may advise people who get a mechanical valve to take blood thinners for life to prevent blood clots from forming in the heart.
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What Are The Symptoms Of Leaky Heart Valves
As surprising as it seems, there are often no symptoms of leaking heart valves. There are many healthy people who have slightly leaky valves that cause no symptoms and are only diagnosed through a routine physical exam. Sometimes even a severe leak causes no or few symptoms.
More often, however, severe leaks impact the forward flow of blood through the heart, which can mimick symptoms of congestive heart failure. Symptoms include shortness of breath, both when exerting yourself and when lying flat, leg swelling and other fluid retention, lightheadedness, rapid heartbeat, heart palpitations or flutters, fatigue, chest discomfort, or rapid weight gain. Any of these symptoms are an indication to schedule an appointment with your doctor to check for leaky valve or other heart conditions.
What Is The Outlook For A Bicuspid Aortic Valve
Survival rates for aortic valve surgeries are relatively high. People who have valves repaired may need subsequent repairs made if they are young. Valve replacement procedures are usually permanent.
A 2021 study comparing survival rates among various bicuspid aortic valve patient groups suggests that low risk individuals between the ages of 60 and 64 experienced a median survival time after surgery of about 16 years.
Those age 85 and older had about a 6-year survival expectancy. Individuals in high risk groups averaged somewhat lower life expectancy outcomes.
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The Clues Can Be Subtle: Monty’s Recliner
Monty is 75 years old, and his doctor had noted his heart murmur several years ago. He recently went to visit his son David for a few days.
- Each night Monty would go to bed in the guest bedroom and the next morning David would find him sleeping in the family room recliner.
- David asked if he was unable to get comfortable in the bed, and Monty replied that he felt unable to get a deep breath when lying down and the recliner seemed to help.
- Monty insists that its not a problem, but David wonders if he should urge him to check in with his health care provider.
Would you recognize this behavior as a possible sign of valve disease progression?
Does Mitral Valve Regurgitation Cause Fatigue
Mitral valve regurgitation refers to the backflow of blood from the left ventricle into the left atrium. There are many reasons for mitral valve regurgitation including but not limited mitral valve prolapsed, damaged tissue cords, rheumatic fever, endocarditis, heart attack, cardiomyopathy, trauma, and congenital heart defects. Mitral valve prolapse seems to be the most common cause of mitral regurgitation. Mitral regurgitation can be mild, moderate or severe.
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What Else Should I Ask My Healthcare Provider
To learn more about how a leaky heart valve is affecting you, consider asking your healthcare provider:
- Which valve is affected?
- What is causing the leaky valve?
- What lifestyle changes might help?
- Should I have a procedure to repair or replace the heart valve?
- Can I still do all of my normal activities?
- What is my prognosis?
A note from Cleveland Clinic
A leaky heart valve doesn’t close properly when the heart beats. Heart valve leakage can place extra strain on the heart and cause symptoms or even heart failure. If you have symptoms of a leaking heart valve, talk to your healthcare provider. There are many ways to repair or replace a valve, and lifestyle changes may help.
Last reviewed by a Cleveland Clinic medical professional on 03/09/2021.
References
What Are The Symptoms Of Mitral Valve Prolapse
Mitral valve prolapse may not cause any symptoms. The following are the most common symptoms of Mitral Valve Prolapse. However, each individual may experience symptoms differently. Symptoms may vary depending on the degree of prolapse present and may include:
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Palpitations. Palpitations are the most common complaint among patients with Mitral Valve Prolapse. The palpitations are usually associated with premature ventricular contractions , but supraventricular rhythms have also been detected. In some cases, patients may experience palpitations without observed dysrhythmias .
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Chest pain. Chest pain associated with Mitral Valve Prolapse is different from chest pain associated with coronary artery disease and is a frequent complaint. Usually the chest pain is not like classic angina, but can be recurrent and incapacitating.
Depending on the severity of the leak into the left atrium during systole , the left atrium and/or left ventricle may become enlarged, leading to symptoms of heart failure. These symptoms include weakness, fatigue, and shortness of breath.
The symptoms of mitral valve prolapse may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
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How Does The Aortic Valve Work
When your heart beats , the flaps of the aortic valve open up and blood is pushed into the aorta.
Blood moves through the aorta and down through the chest and abdomen. The blood then travels through a network of smaller arteries and capillaries to nourish organs, muscles, and other tissue.
When the heart rests, the flaps close tightly so that no blood flows back into the heart. A tricuspid valve with three leaflets can usually open easily and close securely.
With a bicuspid valve, the leaflets may be thicker than usual, making them harder to open properly. This condition, called aortic valve stenosis, can cause the heart to work harder to pump blood out to the aorta.
Sometimes, the leaflets become thicker over time due to blood flowing unevenly across the valve. This means that some people with a bicuspid aortic valve will start out with regular function, but it will deteriorate over time.
In other cases, the bicuspid valve cant close tightly. When blood flows back from the aorta through the leaky valve and into the heart, the condition is called aortic regurgitation. This can force the heart to work harder than usual.
Leaky Heart Valves Causes
The causes of a leaky valve depend on which valve is affected. A leaky aortic valve may be due to high blood pressure, an infection of the heart valve known as endocarditis, Marfan Syndrome, or rheumatic heart disease. The aortic valve may also be leaky if it only has two flaps as opposed to the normal three. A leaky mitral valve could be due to mitral valve prolapse in which the valve closes improperly, an enlarged heart, endocarditis, or rheumatic heart disease.
A leaky tricuspid valve is considered to be relatively normal, so long as it isnt significant, however high blood pressure in the pulmonary artery may cause the leak to be severe. Finally, a leaky pulmonary valve may be caused by elevated blood pressure in the pulmonary artery or previous surgery undergone as a child to correct a severe defect.
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What Are The Possible Complications Of A Bicuspid Aortic Valve
A bicuspid aortic valve causes the heart to have to pump harder to make sure enough blood reaches the entire body. This can cause complications.
A 2019 review of studies suggests that most people with a bicuspid aortic valve will develop a related complication.
Some of the more common complications include:
- aortic stenosis
- aortic regurgitation
- heart failure, where a weakened heart can no longer pump blood well enough for the bodys demands
- aortic aneurysm, where a bulge forms in the aorta, raising the risk of it rupturing
- endocarditis, an infection of the heart
- irregular heart rhythms , where the heart beats irregularly instead of in the usual synchronized rhythm
People with a bicuspid aortic valve should be screened for aortopathies, a group of diseases that affect the aorta. Congenital heart defects can often lead to an aorta that is enlarged or at risk for rupture, according to
How Is Mitral Valve Prolapse Diagnosed
Sometimes, the flaps of the mitral valve make a sound when they close, like when you flick or snap a towel, called a “click.” A doctor might hear this noise when listening to the heart with a stethoscope and find the condition that way.
If the flaps do not close evenly or fit together well, blood can leak back into the left atrium. This is called mitral regurgitation. When theres more than a little leakage , the doctor may hear a whooshing sound as some blood moves backward into the left atrium. This is a heart murmur, and its heard between the normal lub-dub sounds of the heartbeat.
When a click and murmur are heard together, the click happens first , followed by the murmur .
In kids, doctors might find mitral valve prolapse during a regular checkup. When listening to the heart with a stethoscope, the doctor might hear a click or a murmur. If so, the doctor will send the child to a pediatric cardiologist, a doctor who diagnoses and treats heart conditions in kids.
The cardiologist will do an exam, listen to the heart, and possibly order tests such as:
- an echocardiogram , which uses sound waves to create a picture of the heart and its blood flow. If a child has mitral valve prolapse, the bulging valve flaps usually are seen when the heart beats.
- an electrocardiogram , which records the hearts electrical activity
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How Is A Leaky Heart Valve Treated
Some cases dont require any treatment. But treatment may be necessary if the condition:
- Affects your ability to have an enjoyable or productive life.
- Causes troubling symptoms.
- Places a strain on your heart.
- Threatens to shorten your life span.
If needed, there are many types of heart valve surgery to repair or replace a leaky valve. Your healthcare team will help you decide what procedure is right for you. The decision will be based on which valve is involved and the particular cause of the leak.
Some examples of procedures include:
- Valve repair, which often includes an annuloplasty which is a ring that is used to tighten or reinforce the leaky valve.
- Procedures to place a clip on the valve.
- Surgery to replace the leaking valve with a device made of carbon and metal.
- Surgery to replace the valve with one donated from a deceased human or animal.
How Is Leaky Heart Valve Treated
For mild heart valve leakage, treatment is usually not required. The doctor may suggest observation and follow-up. Patients who are symptomatic may be prescribed medication. Heart surgery to repair or replace the leaky valve may be advised for severe leakage or regurgitation. All patients with asymptomatic and symptomatic leaky heart valves would be advised lifestyle modifications, which would be beneficial to the heart and overall health.
Lifestyle modifications include:
- Regular exercise such as walking or yoga before engaging in rigorous exercise or sports, it is advised to consult a doctor
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What Are The Signs And Symptoms Of A Leaky Heart Valve
Many healthy people may have one or more valves that are slightly leaky, which do not cause any problems. The severity of the symptoms depends on the severity of the heart valve leak.
If heart valve leak is severe, it can affect the flow of blood through the heart causing the symptoms of congestive heart failure, which include:
- Shortness of breath
- Leg swelling or puffiness over the face
- Failure to thrive
What Is Mitral Valve Regurgitation
The mitral valve is a one-way valve located between the heart’s left upper chamber and the heart’s lower left chamber .
When the heart contracts, the mitral valve’s two flaps or leaflets open to allow blood to move out of the atrium and into the ventricle.
When the mitral valve does not close properly, blood leaks back into the left atrium. This is known as mitral valve regurgitation or mitral insufficiency, which is one of the more common types of heart valve disorders.
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How Is Heart Valve Disease Diagnosed
If you are having symptoms, your doctor will suggest doing some tests to see how your heart is working.
The most common test is an echocardiogram. Your doctor might also suggest a chest x-ray or an ECG .
If you arent having symptoms, your doctor can still pick up signs of possible problems with your heart if they listen to the rhythm of your heart. If your doctor hears a murmur , they may refer you for further tests to see how your heart is working.
First Uk Patient Has Pioneering Procedure To Fix Leaking Heart Valve
A cutting-edge procedure to repair leaking heart valves without the need for open-heart surgery has been carried out at Royal Brompton Hospital in a UK first. The innovative technique uses a piece of equipment known as the Harpoon device to repair a leaking mitral valve through a small incision in the chest, replacing the need for major conventional surgery.
Around one in 50 adults in Britain is thought to have mitral valve disease. Mitral regurgitation occurs when the mitral valve collapses and fails to close properly. As a result, blood flows backwards through the valve when the heart contracts, compromising the function of the heart. The condition can cause breathlessness, fatigue, dizziness, chest pain and, if left untreated, can lead to heart failure and death.
Mr Neil Moat, consultant cardiac surgeon at Royal Brompton Hospital, performed the new technique for the first time in the UK as part of a new clinical trial, with the help of imaging colleague Dr Alison Duncan.
Repairing a leaking mitral valve usually requires open-heart surgery, which involves making a large incision to the chest and dividing the breastbone. Patients require the support of cardiopulmonary bypass, commonly known as a heart-lung machine, so the operation can take place while the heart is not beating.
The new method takes half as long to perform, is thought to halve the time patients spend in hospital and leads to shorter overall recovery times. It is like fixing broken strings of a parachute.
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