Download Valve Disease - Dr Diana Holdright

Dr. Diana R. Holdright
MD, FRCP, FESC, FACC, MBBS, DA, BSc.
Consultant Cardiologist
GMC number: 2915180
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Tel: 020 7631 4346
Fax: 020 7224 2204
The Harley Street Clinic Diagnostic Centre
13-18 Devonshire Street, London W1G 7AE
[email protected]
www.drholdright.co.uk
Cardiac Conditions - Valve Disease
The four chambers of the heart are separated by one-way valves to ensure efficient forward flow of blood
from chamber to chamber and into the main blood vessels, the aorta and pulmonary artery. There are
four main valves (see figure), two on the left side, the aortic valve and mitral valve, and two on the right
side, the pulmonary valve and tricuspid valve.
There are two main types of valve disease: narrowing, which makes it harder for the heart to propel blood
through the valve; and leakage, such that the blood expelled leaks back across the valve making the heart
pump inefficiently. Some patients will have a mixture of the two. Valve disease can be congenital,
meaning that a patient is born with an abnormal valve, or acquired, developing in later life. In the past the
most common cause of valve disease was rheumatic fever, but this is now rarely seen in the Western
world. As life expectancy has gradually increased the most common cause of valve disease is
degenerative, due to wear and tear over the years; this is not surprising when you consider that the heart
beats 90,000 to 100,000 times every day and all four valves open and close with every beat. Valves are
extremely fine structures, less than 4 mm thick, and are subjected to tremendous pressure gradients
across them, averaging more than 100 mmHg on the left side of the heart with every beat.
In the early stages of valve disease there are no symptoms, although the noise generated by a narrowed
or leaking heart valve may be detectable as a heart murmur using a stethoscope. As the valve disease
progresses, the heart begins to feel the strain and symptoms such as breathlessness, reduced exercise
capacity, fatigue, palpitations and fluid retention begin to develop. It is important that valve problems are
picked up early, before the heart muscle becomes strained, since effective and timely treatment with
medicines, and valve replacement or repair if necessary, minimise the risk of permanent damage to the
heart.
Dr. Diana Holdright Ltd t/a Dr. Diana R. Holdright
Registered in England: Company Number 8089590, Registered Address: 7 Lindum Terrace, Lincoln LN2 5RP