There are four heart valves. Acting as one-way doors are the valves. Blood can enter the lower chambers (ventricles) of the heart by passing via one set of valves, which opens. To allow blood to be pushed out of the ventricles, a different set of valves opens.

To allow all of the blood that is available to enter the chamber, the valves must fully open. Additionally, they must be sealed tightly to prevent blood from leaking back into the empty chamber.

When the valves do not function as they should, valve disease develops. Sometimes a condition is congenital, meaning it exists from birth. Other times, an infection or condition like rheumatic fever causes the valves to become damaged.

Despite having four heart valves, they can be divided into two groups:

Atrioventricular valves - control blood flow from the upper chambers (atria) to the lower chambers (ventricles). The tricuspid valve connects the right atrium to the right ventricle. The valve between the left atrium and the left ventricle is the mitral valve.

Blood flow from the ventricles to the rest of your body is regulated by semilunar valves. The pulmonary valve allows blood to exit the right ventricle and travel to the lungs. The aortic valve allows blood to exit the left ventricle and travel to your body.

The heart's left ventricle serves as its primary pumping chamber. Therefore, the mitral valve (which enters the left ventricle) or the aortic valve (which exits the left ventricle) are the valves where symptoms of valve illness are most obvious. These cardiac valves commonly experience one of two issues:

• Opening : If the valve is stenotic, which is when the valve becomes thicker and narrower, it may not fully open. Blood flow via the heart and/or to the body is slowed by stenosis.
• Closing : If the valve does not close completely, blood may seep back into the heart chamber. We refer to this as regurgitation. Regurgitation might result in your body receiving less blood than usual.

What is the cause of Valve Disease?

The causes of valve disease are not always known. But the following are common causes:

• Congenital heart problem (a defect present from birth)
• Rheumatic fever
• Heart infection called endocarditis
• Prior heart attack

What are the symptoms of Valve Disease?

Symptoms of valve disease can include:

• Weakness and fatigue
• Shortness of breath
• Heart palpitations (feeling that the heart is racing or that the heartbeat is irregular)
• Chest discomfort or tightness
• Dizziness or fainting (syncope)
• Chest infections or coughing (sometimes coughing up blood)
• Swollen legs and feet

The symptoms of valve disease might not be present in you. However, with time, your heart muscle may weaken. Even worse, you can get heart failure or an arrhythmia like atrial fibrillation. You'll probably have symptoms if valve disease has harmed your heart muscle. However, your doctor will attempt to detect valve problems before your heart muscle is harmed.

What tests could I have?

• Cardiac Catheterization Chest X-ray
• Echocardiogram Electrocardiogram (ECG or EKG) Holter Monitoring
• MRI
• Stethoscope Test
• Stress Test

Cardiac Catheterization

What is a cardiac catheterization?

A treatment known as a cardiac catheterization involves inserting a tiny, flexible tube known as a catheter into a blood vessel. Typically, a blood vessel in your groin (or occasionally, your arm) is used to insert the catheter. Your doctor "steers" the catheter gently in the direction of your heart or a potential blocked blood vessel. Numerous examinations and treatments involving the heart and blood vessels begin with a cardiac catheterization.

For instance, the initial step in an angiography is frequently a cardiac catheterization. Your doctor uses a catheter to inject dye into your arteries during an angiography to detect any blockages. A catheterization allows your doctor to:

• Measure blood pressure in your heart or lungs Take a tiny sample (a biopsy) of your heart muscle
• Determine how much oxygen is in your blood
• Measure the amount of blood flowing through your heart and blood vessels
• Do an electrophysiology (EP) study to check the electrical system in your heart

During a cardiac catheterization, your doctor may also treat any blocked blood vessels with one or more of these procedures to improve blood flow:

• An atherectomy– using a catheter with a cutting tool to clear plaque from an artery
• A balloon angioplasty– using a catheter with a balloon that expands and presses plaque against the side of an artery
• A stent implant-inserting a tiny mesh tube into an artery to help keep it open after plaque has been cleared

What can I expect?

It will be done in a "cath lab" for your procedure. After getting a cardiac catheterization, you undress and change into a hospital sheet or gown. An IV line is inserted into your arm while you are lying on an examination table. Throughout the procedure, the IV provides medication and fluids. You feel sleepy from the medication, but not out cold. Your heart's activity is tracked by electrodes on your chest throughout the process. Regularly taking your blood pressure is also done with an arm cuff. The catheter is inserted through a tiny incision made by the doctor, usually in the groin. You won't feel any pain because the area will be numbed, but as the catheter is inserted, you might feel some pressure. Since you won't be unconscious, your physician or nurse may interrogate you to make sure you're not experiencing any pain, for example, during the test. You may then spend the night in the hospital. The majority of patients recover rather quickly.

Chest X-ray

What is a chest x-ray?

A chest x-ray produces an image of your heart, lungs, and nearby blood vessels. It reveals the:

• Sizeand shape of your heart
• Presenceof fluid around your lungs
• Positionand shape of your large arteries

An x-ray can help diagnose many different conditions, including heart diseases. And if you have a cardiac device like a pacemaker, the x-ray also shows the device and the coated wires (leads) that carry the energy to your heart.

What can I expect?

When getting a chest x-ray, you take off your clothes above the waist and put on a hospital gown. You are partially protected from any extra radiation by a shield, a large, flexible lead apron. (The image is produced by X-rays with very little radiation.) While the image is being captured, you maintain a still position in front of the x-ray machine. Typically, your doctor will want two views: one from the side and one from the back.

Echocardiogram

What is an echocardiogram?

The term "echo" refers to a three-dimensional, moving image of your heart obtained during an echocardiogram. Doppler ultrasound is used in an echo. It resembles the ultrasound examination given to expectant mothers. People cannot hear the sound waves that are emitted by the echo machine. The waves travel through the heart and over the chest. The heart's "echo" or reflection of the waves reveals:

• The shape and size of your heart
• How well the heart valves are working
• How well the heart chambers are contracting
• The ejection fraction (EF), or how much blood your heart pumps with each beat

What can I expect?

You undress up to your waist for an echocardiogram, don a hospital gown, and lie on a table. To aid in sound transmission, the technician applies gel to your side and chest. The technician will then move a transducer, which resembles a pen, around on your side or chest. The transducer captures the sound waves' echoes. On a specialized monitor, a moving image of your heart is displayed concurrently. Depending on the part of the test you're taking, you might be asked to lie on your back or your side. In order for the technician to get a clear picture of your heart, you might also be asked to briefly hold your breath. It's easy to test for an echo. The transducer swings back and forth, applying only slight pressure to your skin.

Electrocardiogram (ECG or EKG)

What is an ECG?

An electrocardiogram (ECG or EKG) shows the electrical activity of your heart. Your heartbeats, or cardiac rhythms, are detected and recorded by the ECG. On a piece of paper strip, the results are printed. Also useful to your doctor is an ECG.

diagnose whether:

• You have arrhythmias
• Your heart medication is effective
• Blocked coronary arteries (in the heart) are cutting off blood and oxygen to your heart muscle
• Your blocked coronary arteries have caused a heart attack

In all, there are three kinds of tests that record your heart's electrical activity, each for a different period of time:

• Electrocardiogram (ECG)-done in the doctor's office. It records your heart rhythms for a few minutes.
• Holter monitoring– records and stores (in its memory) all of your heart rhythms for 24-48 hours.
• Event recorder-constantly records your heart rhythms. But it stores the rhythms (in its memory) only when you push a button.

What are the parts of an ECG strip?

The peaks on an electrocardiogram (ECG) strip are called waves. Together, all the peaks and valleys give your doctor important information about how your heart is working:

• The P-wave shows your heart's upper chambers (atria) contracting
• The QRS complex shows your heart's lower chambers (ventricles) contracting
• The T-wave shows your heart's ventricles relaxing

What can I expect?

You take off your clothes up to your waist, put on a medical gown, and lie down on a table to have an electrocardiogram (ECG). Your chest, neck, arms, and legs may receive as many as 12 electrode patches. The electrodes on the ECG equipment sense the electrical signals coming from the heart. The device then plots a strip of graph paper with the beat of your heart on it.

Holter Monitoring

What is Holter monitoring?

A tiny recording device known as a Holter monitor is used in holter monitoring. Your heart's electrical activity is monitored and recorded by the device, typically for 24 to 48 hours.

Your doctor can use holter monitoring to determine whether you have arrhythmias, or irregular cardiac beats. Even though arrhythmias are uncommon, it is nevertheless crucial for your doctor to be aware of them and to treat them.

There are three separate tests that each capture the electrical activity of your heart for a different length of time:

• Electrocardiogram (ECG)-done in the doctor's It records your heart rhythms for a few minutes.
• Holter monitoring records and stores (in its memory) all of your heart rhythms for 24-48
• Event recorder constantly tracks your heart But it stores the rhythms (in its memory) only when you push the button.

Any of these three tests' heart rhythms have the same appearance when written out because the electrical impulses resemble peaks and valleys. A doctor might advise Holter monitoring if you experience symptoms at least once every two days or more frequently.

If you experience any symptoms during the test, your doctor might ask you to note them down. Fainting, lightheadedness, or chest fluttering are possible symptoms. It's important to keep track of when and how long the symptoms last. Additionally, your doctor could urge you to keep a journal of the times you work out, take medication, or become agitated. This can assist your doctor in determining whether your heart rhythms and your symptoms or activities are related.

What can I expect?

On your chest, up to seven 4–7 sticky patches known as electrodes are applied.

Wires on the Holter monitor are connected to the electrodes. Your heartbeat is detected by the electrodes, and it is captured and stored by the monitor. Taking a shower or bath prior to starting the Holter monitoring is advised, as the electrodes cannot become wet while the test is being conducted. The Holter monitor itself is about the size of a compact, carry-along tape recorder. It is simple to wear on a shoulder strap or a belt.

You should be able to use the Holter monitor and carry out the majority, if not all, of your daily tasks at home. When the Holter monitor is monitoring your heart rhythms, you won't feel anything. You give the monitor back after 24 to 48 hours. A technician reviews the recordings, makes a note of any arrhythmias you may have had, and compiles a report for your physician.

Magnetic Resonance Imaging (MRI)

What is magnetic resonance imaging (MRI)?

Using magnets, radio waves, and computer technology, magnetic resonance imaging (MRI) can provide images of various bodily parts. MRI is particularly helpful for capturing precise pictures of soft tissues. For instance, a lot of people get an MRI to examine their blood arteries and/or hearts.

In a sizable, tube-shaped machine, MRI is performed. A powerful magnetic field is produced by coils inside the machine's walls. Radio waves are sent and received by additional coils inside the machine's walls. Your body responds to the radio waves by sending out a few weak signals. A computer builds three-dimensional representations of the interior of your body as the device detects the weak signals.

The images can reveal:

• Blockages in blood vessels
• The size and thickness of your heart's chambers
• Damaged muscle from a heart attack
• How your heart valves are working

What can I expect?

You take off your clothes and put on a hospital sheet or gown before your magnetic resonance imaging (MRI). Remove any jewelry, hearing aids, or other metal objects before entering the MRI room. If you have metal on your body, you run the risk of getting hurt because the magnets in the MRI machine are very powerful. Most people who have a cardiac device, such as a pacemaker, implantable defibrillator, or device for heart failure, should generally avoid getting an MRI. Before scheduling an MRI, all cardiac device users should check with their doctor.

You lie down on a mobile table in the MRI room, where an intravenous (IV) line is inserted into your arm. During the procedure, the IV administers medications and fluids. The technician might inject contrast dye into the IV, for instance.

Your chest is covered with patches known as electrodes. Electrodes are connected to wires on an electrocardiogram (ECG). Your heart's activity is monitored during the procedure by the electrodes and ECG. Your blood pressure is frequently taken using a blood pressure cuff on your arm. Despite the MRI scanner's lack of any moving parts, the table you are lying on slides into the device. To block out some of the thumping sounds made by the machine, you can wear headphones or earplugs. For some of the test, the technician may instruct you to lie very still or hold your breath. However, you might notice twitching in the muscles of your fingers or toes.

Stethoscope Test

Often, a relatively straightforward test—listening to your blood flow with a stethoscope—can detect valve trouble. A murmur, or swishing sound, made by your heart as blood flows past it may be an indication of a valve issue. Innocent murmurs are those murmurs that are unharmful. If you have a murmur, your doctor may only listen for it when you go in for your annual checkup. There are more significant heart murmurs. In this situation, your doctor might also suggest one or more follow-up exams.

Stress Test

What is a stress test?

A form of electrocardiogram (ECG or EKG) is a stress test. Regular ECGs look at your heart's resting rhythm. Stress tests look at how your heart reacts to strain or activity. Stress testing come in a variety of forms. However, the majority of stress tests are done to determine whether or not your heart is receiving enough blood and oxygen.

Stress tests are frequently used to simulate symptoms like shortness of breath or chest pain. The test examines:

• Heart rate
• Blood Pressure
• Your heart's electrical system

The test can show:

• If you have coronary artery disease (CAD)
• If you might be at risk for a heart attack
• The cause of symptoms like chest pain (angina)
• Whether you have irregular heart rhythms (arrhythmias)
• Whether treatment- medications or an implanted device- has improved your heart and blood vessel function in one of the simpler types of stress tests, you walk on a treadmill or pedal a stationary bike. You begin at an easy pace. The machine is slowly adjusted to make you work harder. You continue exercising until you feel symptoms or until you get too tired. A stress test is also known as an exercise test, a treadmill test, or an exercise ECG.

An intravenous (IV) line is usually placed in your arm during a nuclear stress test by the technician or nurse. Through the IV, a tiny quantity of thallium, a radioactive substance, is injected into your blood. Due to the thallium's ability to provide your doctor with additional information regarding your heart's blood and oxygen intake, a nuclear stress test is typically performed alongside a regular stress test. However, even if you are unable to exercise, a nuclear stress test can still be performed because another drug can be administered to make your heart beat faster.

Following the injection of thallium, you lie on a table in front of a specialized camera. The camera then captures pictures of your heart. Less thallium is delivered to any area of your heart that doesn't get enough blood and oxygen. As a result, on the picture, that area of your heart is lighter in color.

What can I expect?

During a stress test, you should undress up to your waist and change into a hospital gown. You may have up to 12 electrodes—small patches—applied to your arms, legs, chest, and neck. The electrocardiogram's (ECG) wires are connected to the electrodes. Next, each electrode's electrical activity in your heart is recorded by the machine. Your arm is also fitted with a blood pressure cuff, and it is regularly monitored. In addition, an IV will be placed if you have a nuclear stress test (usually into your arm).

Although it occasionally replicates painful symptoms, a stress test does not typically cause any pain. On the other hand, because you exercise until you're extremely exhausted, the test works your muscles. Throughout the test, a nurse typically speaks with you and gives you instructions. For ten to fifteen minutes after you stop exercising, the nurse keeps an eye on your symptoms, blood pressure, and heart rate.

What are the treatment options?

The better the prognosis and management of valve disease, the earlier. Because valve illness can damage the heart muscle, early treatment is crucial. Your doctor may initially only keep track of the condition to determine if it is stable or deteriorating. At some point, your doctor might advise surgery, such as valve replacement or repair. It is best to get surgery even if you feel great before valve disease damages your heart muscle.

Medications

Currently there are no medications to treat valve disease. However, medications like antibiotics may be used to prevent complications of valve disease.

• Antibiotics
• Anticoag
• uIants
• Diuretics

Procedures

• Valve Repair
• Valve Replacement

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Medications

Tips for Taking Heart Medications

You might wish to learn more about some of the medications you take if you have a heart or blood vessel condition. Some drugs that are frequently recommended for heart or blood vessel disorders are described in this section. Additionally, it offers some advice on how to take your drugs as directed.

Make sure to disclose all prescription medications and dietary supplements you are using to your doctor and any new doctors who will write you a prescription. Then, your doctor can assist in ensuring that you receive the most from your prescriptions. Informing your doctor of this information also helps to prevent negative drug interactions.

Every time you receive a new drug, you might also wish to bring up the following issues with your doctor or nurse:

• The reason you're taking the medication, its expected benefits, and its possible side effects
• How and when to take your medications
• If you take other medicines, vitamins, supplements, or other over-the-counter products

Your heart may occasionally require several months to acclimatize to new drugs. So it's possible that you won't see any progress immediately away. Your doctor's evaluation of the proper dosage can take some time as well.

Blood testing may occasionally be required for patients on heart medicines. The blood tests assist your doctor in determining the proper dosage, assisting in the prevention of negative side effects.

Never alter your medication's dosage or stop taking it on your own initiative because you feel better without it, no longer need it, or don't think it's functioning as intended.

If you have: Be sure to discuss it with your doctor or nurse.

• Questions about how your medications work
• Unpleasant side effects
• Trouble remembering to take your pills
• Trouble paying for your medications
• Other factors that prevent you from taking your medications as needed
• Questions about taking any of your medications

And don't hesitate to ask your pharmacist if you have questions about how and when to take your medications.

Antibiotics

You run the risk of developing endocarditis if you have mitral valve regurgitation. An infection of the heart's valves and inner lining is known as endocarditis. Your doctor might advise taking antibiotics before undergoing surgery or visiting the dentist in order to help prevent endocarditis. Never deviate from your doctor's recommendations for when and how to take your antibiotics.

In some situations, drugs may be used to treat the signs and not the cause of valve disease.

Anticoagulants (Blood Thinners) You can understand the purpose of anticoagulants by looking at the root words of the term. Anti = counter or against; coagulant = thicken or clot.

Some Generic (and Brand) Names All medications are approved by the Food and Drug Administration (FDA) for a specific patient group or condition. Only your doctor knows which medications are appropriate for you.

• aspirin
• clopidogrel (Plavix)
• ticlopidine (Ticlid)
• warfarin (Coumadin)

What They're Used For

to lower the possibility of blood clots that can cause a stroke and other illnesses

How They Work

Although they don't actually thin the blood, anticoagulants are sometimes referred to as blood thinners. Instead, they aid in preventing blood clots from developing.

These drugs address ailments brought on by atherosclerosis, or plaque-clogged arteries. A blood clot can result from plaque accumulation.

• A blood clot in the coronary arteries (which carry blood to the heart muscle) can cause angina (chest pain). A clot or blockage in the coronary arteries is called coronary artery disease (CAD) and could lead to a heart attack.
• A blood clot in the carotid arteries (in the neck) can travel to the brain and cause a stroke.
• A blood clot in the vessels in the arms or legs, called peripheral vascular disease (PVD), can cause pain.

Taking anticoagulant medications can: Decrease the stickiness of the blood

Reduce the likelihood of blood clots forming

Diuretics (Water Pills)

Diuretics help your body get rid of extra water.

The Food and Drug Administration (FDA) has given its approval to all drugs for a certain patient population or ailment. The right medication for you is something only your doctor can tell you.

Some generic (and brand) names

• amiloride (Midamor)
• bendroflumethiazide (Naturetin)
• bumetanide (Bumex)
• chlorothiazide (Diuril)
• chlorthalidone (Hygroton, Thalitone)
• eplerenone (lnspra)
• ethacrynic acid (Edecrin)
• furosemide (Lasix)
• hydrochlorothiazide (Microzide, Oretic)
• indapamide (Lozol)
• methyclothiazide (Enduron)
• metolazone (Zaroxolyn)
• polythiazide (Renese)
• spironolactone (Aldactone)
• torsemide (Demadex)
• triamterene (Dyrenium)

What they're used for

• To lower blood pressure
• To reduce edema (swelling caused by excess fluid in your body often in the legs and feet) associated with conditions such as heart failure

How they work

Some diuretics function by triggering the kidneys to excrete more sodium (salt) in urine. Sodium aids in removing water from the blood. Your blood pressure drops when the amount of fluid in your body lowers.

Diuretics also alleviate other symptoms including breathlessness. That's because these symptoms may be brought on by an accumulation of fluid in your lungs.

Valve Repair

Some diseased valves can be repaired:

• Calciumdeposits can be removed from the valve, allowing it to close
• Partof the valve can be surgically reshaped, allowing it to close
• Ifthe valve opening is too wide, it can be tightened with Valve repair is a major surgery requiring general anesthesia.

Procedures

Valve Replacement

What is a valve replacement?

Your doctor may elect to do nothing in the event that your heart valve is damaged for a period. However, with time, a damaged valve may begin to impact the left ventricle, the heart's lower chamber. Consequently, your doctor might suggest replacing the valve. Your surgeon replaces the worn-out valve with a new one during surgery. Before the left ventricle is harmed, the heart valve needs to be replaced.

The replacement of a valve is a serious procedure that calls for general anesthesia.

How is the surgery done?

the heart must be perfectly motionless for the doctor to operate. As a result, you will be given drugs to stop your heart. Then, a heart-lung machine performs the functions of the heart and lungs:

• It increases blood oxygen levels, just as the lungs would.
• It circulates blood throughout the body and returns blood to the heart.

The broken valve is removed by your doctor, who then sews the new valve into place. Sometimes an organ donor provides the healthy valve needed for this procedure. A mechanical valve consisting of plastic and metal is more frequently implanted by a doctor.

What can I expect?

Usually, a few hours prior to your procedure, you are instructed to refrain from eating or drinking anything. An intravenous (IV) line is inserted into your arm when you are lying on an examination table. During surgery, the IV administers fluids and drugs. Then, after being taken into the operating room, you are given a drug to make you asleep throughout the procedure. You must stay in the hospital for a few days following surgery. Even though there may be pain at the incision site for a few weeks, painkillers are available. Recovery may take 6 to 8 weeks at home.

A valve infection (endocarditis) is more likely to occur after valve replacement surgery. As a result, your physician will prescribe antibiotics for you.