Valvular heart disease, which is an abnormality of the heart valve, can be curedProfessor Eui-Young Choi, Department of Cardiology, Severance Hospital

 

 

 

 

 

 

 

 

 

 

 

 

What is valvular heart disease? Definition of valvular heart disease

 

 

The heart is also said to be circulatory. This heart acts as a pump. As I learned as a student, the heart is made up of the left atrium, the right atrium, the left ventricle, and the right ventricle. There has to be a tissue where the door has to open and close as the blood flows through each room. That tissue is called a 'heart valve'. Because there is one valve in each atria and ventricle, there are four valves in the heart, and when these valves open, blood passes from the atria to the ventricles, and when the valves in the aorta open, blood flows to the aorta or pulmonary artery. The heart valve is a great way for blood to circulate.

 

This problem is called valvular heart disease. When calcification forms in this valve and it hardens, it doesn't open well. Just as the fat of our door does not open well when it rusts, if the arteriosclerosis is severe and narrows, or if the valve becomes loose when it needs to be closed again, blood leaks backwards. So, narrowing is called stenosis, and not closing is called obstructive insufficiency.

 

 

So, what are the symptoms of a valve failure? In fact, there are no typical symptoms of valvular heart disease. In the early stages, most people don't have any symptoms.

 

Some people say they have shortness of breath when they have valvular heart disease, while others say they have swelling. In addition, young people may report that they are rather excited.

 

The most common valvular heart disease 1: Aortic valve stenosis

 

 

The most common valvular diseases are aortic valve stenosis and mitral valve insufficiency. First, let's talk about aortic valve stenosis.

 

This picture is of the mitral valve, which is the aortic valve. As it ages, it hardens and becomes calcified. This calcification is called arteriosclerosis, and this arteriosclerosis in the valve is called aortic valve stenosis.

 

The point here is that even healthy people can go this way. This is something that not everyone can avoid because it is due to aging, but if you take care of it, you can slow down its progression a little.

 

 

The graph above shows the symptoms and survival rate of aormologous valve stenosis published in 1968. The disease is mostly asymptomatic. However, if you experience symptoms such as chest pain, fainting, or shortness of breath, there is a risk that you may die suddenly. Therefore, it is very important to detect this aortic valve stenosis early. If left alone, the average survival rate is only two years. Therefore, if it is detected early and treated quickly, the survival rate increases, so it can be said that valvular disease is a disease in which early diagnosis is very important.

 

The most common valvular heart disease 2: mitral valve insufficiency

 

The narrowing of the valve is described as aortic valve stenosis. Mitral valve insufficiency simply means leaking blood. Mitral valve insufficiency is a degenerative change that causes the valve to shrivel and crack and leak blood, which is a bit congenital.

 

In addition, when bacteria enter the body during hospital treatment or antibiotic treatment, they can attack the valve and destroy it. This can lead to tearing and mitral valve insufficiency. Mitral valve insufficiency is usually asymptomatic, but if left untreated, 40% of people will develop some symptoms or die after five years. Therefore, even if there are no symptoms, it is very important to check the valve through an ultrasound examination because it is a disease that can lead to death in severe cases if left untreated.

 

It can be detected by auscultation, but it cannot be measured precisely by auscultation. Ultrasound can determine whether the disease is mild or severe, and nowadays you can even see the heart moving with a three-dimensional echocardiogram.

 

Valvular heart disease, how to treat it?

 

So, what should you do if you've been diagnosed with valvular disease? First of all, it is important to monitor the progress and adjust your lifestyle, and if you have symptoms such as shortness of breath, you will need medication. Medication can prevent the progression of severe disease and improve symptoms. The problem is in the middle of nowhere. In severe cases, surgery is necessary because it cannot be cured with medication.

 

Previously, the surgical method was to use iron valves or valves from pigs and cows. However, there is now a trend to use stent-like treatments without surgery.

 

 

If you look at the picture, there is a cylindrical iron, and this is a stent. This stent is a stent with a valve inside. You don't need to open the heart, you just need to inject it into the aorta. Once it's straightened, there's a valve inside it that opens and closes. In the case of mitral valve insufficiency, we also treat it so that the leak can be blocked with a clip to prevent blood from leaking.

 

There's nothing complicated about valvular disease. Valvular heart disease can be diagnosed with a stethoscope, but an echocardiogram is recommended for a more precise diagnosis. Severe heart valve disease requires surgery or procedures. If it is not detected too late, it can be cured. So, there's nothing to be afraid of. More importantly, mild or moderate valvular disease found during a medical examination does not require surgery or procedures. Since it is necessary to prevent further progression and to treat it when it progresses, it is important to make good lifestyle adjustments and accurately monitor the progress of valve disease when mild or moderate valvular disease is detected.

 

How often should I have an echocardiogram at different ages?

 

In fact, echocardiography is an expensive test, and if you have symptoms, it is beginning to be covered by medical insurance. Before the age of 40, you need to get it when you have shortness of breath, arrhythmias, palpitations, stroke, swelling, etc. 4 Since aortic valve stenosis is more common after the age of 0, it is recommended that you have it at least once every 3 years.

If you are in your 70s or 80s or older, it is recommended that you have an echocardiogram at the time of your medical checkup. This is because people in their 70s and 80s have a significantly higher incidence of aortic valve stenosis. This is the first time you should get it, and if you have mild or moderate valvular disease, you should get it every two years. For example, if you are diagnosed with severe illness but do not have any symptoms, you should have an ultrasound every year or every six months.

 

Should I talk about heart valve disease before going to the dentist?

 

When bacteria enter the body, they can travel through the blood and damage the valves. This is called infective endocarditis. In the past, the biggest cause of such infectious endocarditis was dental care.

When you do dental treatment, the bacteria in your mouth enter your body through the blood that comes from dental treatment. So even if you have gum disease or don't brush your teeth well, bacteria in your mouth can travel through the blood and attack your valves, causing the blood to leak. That's why you should definitely watch out for infectious endocarditis when it comes to dental treatment. That's why it's imperative to talk about heart valve disease before going to the dentist.

 

Is it shortness of breath at the slightest movement, a symptom of regurgitation of the valve?

 

In fact, a very slight regurgitation in the valve is a symptom that occurs in everyone as they age. So, if there is a large amount of reflux into the valve, it can now be the cause of breathing difficulties, but in such mild cases, it is often not the cause of breathing difficulties. In particular, if there is no problem and there is shortness of breath after a professional blood test, it is necessary to check whether there is a problem with the respiratory tract or the bronchial tract such as COPD.

 

Smart devices, are they reliable?

 

Smartwatches are a little less professional. But you can take it with you and see the trends. You can see if your Mac is running well and then suddenly it changes. Then it's time to go to the hospital. So it can certainly help you to do some screening at home. However, it is true that there is a limit to the accurate diagnosis with smart watches now.

 

Is it related to heart valve disease and heart pain?

 

In fact, valvular heart disease is not so common with heart pain. However, there are times when I get exertional chest pain, which is painful when I need a lot of oxygen, such as when I exercise. Imagine arteriosclerosis and a narrowing of the valve. When the aortic valve narrows, less blood flows to the coronary arteries because the opening is narrowed. That's why it can be painful. Especially when you exercise, your blood has to go faster and more, but you can't do it much, so you may get chest pain when you exercise.

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Advice for heart health

 

The first is lifestyle management. At its core, it's a meal. It's important to eat a healthy diet, eat lightly, eat a lot of fiber, and eat a balanced diet with a good balance of carbohydrates and proteins.

 

The second is now regular exercise. I especially like cardio.

 

Finally, if you are 50 years old and have never had an echocardiogram, a do-it-yourself can help detect asymptomatic valvular heart disease or asymptomatic cardiomyopathy.