Did you know that, non-communicable diseases which commonly include heart or cardiovascular disease (CVD), various cancers, chronic respiratory illnesses, diabetes, and so on are estimated to account for around 60% of all deaths and CVDs account for 17.7 million of those deaths? Did you also know that in accordance with the World Health Organization, India accounts for one-fifth of these deaths worldwide?
With the lifestyle becoming more and more stressful with each passing day, there is a sharp rise in heart-related cases. One of the most common heart-related diseases is the valve disease. It is the need of the hour to spread more awareness about this disease in order to catch its progression in time and help the world become more healthy.
Q. What is Valve Disease?
A. Valve disease, also known as valvular heart disease, refers to any condition that affects the functioning of the heart valves. The heart valves play a crucial role in ensuring the unidirectional flow of blood through the heart chambers. When these valves are damaged or diseased, they may fail to open or close properly, leading to disruption in blood flow and impairing the heart’s ability to pump blood efficiently.
In the Indian population, valve disease is a significant health concern. It can affect individuals of all age groups, including children and adults. The most common types of valve disease observed in India include mitral valve prolapse, rheumatic heart disease, and degenerative valve disease.
Q. What exactly are the most common types of valve diseases observed in India? How to diagnose and treat them?
A. The most common types of valve diseases observed in India are as follows:
- Mitral Valve Prolapse (MVP):
Mitral valve prolapse (MVP) is a condition characterized by the abnormal movement or “prolapse” of the mitral valve leaflets during the heart’s contraction. The mitral valve is located between the left atrium and the left ventricle and is responsible for regulating the flow of blood between these chambers. In MVP, the valve leaflets may not close properly, causing them to bulge back into the left atrium during systole (the contraction phase of the heart).
Symptoms:
Mitral valve prolapse can vary in severity, and some individuals may not experience any symptoms. However, in some cases, MVP can cause the following symptoms:
- Palpitations: Many individuals with MVP experience rapid, fluttering, or pounding heartbeats, often accompanied by awareness of the heart’s activity.
- Chest pain: Some people may experience chest discomfort or pain, which can range from mild to severe. The pain is typically not associated with a heart attack but can be distressing.
- Fatigue: Feeling unusually tired or fatigued, even after minimal exertion, is a common symptom of MVP.
- Shortness of breath: Difficulty breathing, especially during physical activity or when lying flat, is a frequent symptom.
- Dizziness or lightheadedness: Some individuals with MVP may experience episodes of dizziness or a feeling of lightheadedness, often associated with changes in body position.
- Anxiety and panic attacks: MVP can be associated with anxiety and panic attacks, although the exact relationship is not fully understood.
Treatment:
- Lifestyle modifications: In many cases, no specific treatment is required for MVP, and individuals can manage their symptoms through lifestyle modifications. These may include avoiding stimulants like caffeine or tobacco, managing stress, maintaining a healthy weight, and getting regular exercise.
- Medications: Medications may be prescribed to manage symptoms such as palpitations, chest pain, or anxiety. Beta-blockers, calcium channel blockers, or anti-anxiety medications may be used to alleviate symptoms and improve the overall quality of life.
- Regular monitoring: Regular follow-up with a cardiologist is crucial for individuals with MVP to monitor the condition and assess any changes in valve function. Echocardiography, an ultrasound of the heart, is commonly used to evaluate the mitral valve and detect any complications.
- Surgical intervention: In rare cases, surgery may be necessary if MVP leads to severe complications, such as significant regurgitation (leakage) of blood through the mitral valve or the development of other serious heart conditions. Surgical options may include mitral valve repair or replacement, depending on the individual’s condition.
It is important to note that treatment plans for MVP may vary depending on the severity of symptoms and associated complications. Therefore, it is essential for individuals with MVP to consult a qualified cardiologist for accurate diagnosis, appropriate treatment, and regular monitoring.
- Rheumatic Heart Disease:
Rheumatic heart disease (RHD) is a condition that develops as a complication of untreated or inadequately treated streptococcal throat infections (a bacterial infection that can make your throat feel sore and scratchy), particularly in individuals with a genetic predisposition. It is characterized by damage to the heart valves, mainly the mitral and aortic valves, due to an autoimmune reaction triggered by the bacterial infection. RHD remains a significant health concern in India.
Symptoms:
- Breathlessness: Shortness of breath, especially during physical activity or when lying flat, is a common symptom of RHD. It occurs due to the accumulation of fluid in the lungs caused by the impaired functioning of the heart valves.
- Fatigue: Individuals with RHD may experience persistent tiredness or a lack of energy, even with minimal exertion. This fatigue can impact daily activities and quality of life.
- Chest pain: Some people with RHD may experience chest discomfort or pain. This symptom is typically related to the strain on the heart caused by impaired valves and reduced blood flow.
- Palpitations: Rapid, irregular, or fluttering heartbeats may occur in individuals with RHD. Palpitations can be distressing and may be accompanied by dizziness or lightheadedness.
- Swollen joints: Joint pain and swelling, particularly in larger joints such as knees, elbows, and ankles, can occur in individuals with RHD. This symptom, known as migratory arthritis, can move from one joint to another.
- Fever: Recurrent or persistent fever, often accompanied by other symptoms of streptococcal infections, such as sore throat, may be an indication of RHD.
Treatment:
- Antibiotics: Antibiotic treatment is crucial for preventing recurrent streptococcal throat infections and reducing the progression of RHD. Regular administration of antibiotics can prevent the occurrence of new rheumatic fever episodes, which further contribute to heart valve damage.
- Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, can help reduce inflammation and relieve symptoms associated with RHD, including joint pain and fever.
- Valve repair or replacement: In cases of severe valve damage or significant functional impairment, surgical intervention may be necessary. Valve repair or replacement surgeries aim to restore normal valve function and improve blood flow through the heart.
- Regular monitoring: Individuals with RHD require lifelong monitoring by a cardiologist to assess valve function, detect any changes or complications, and adjust treatment as needed. Echocardiography, an ultrasound of the heart, is commonly used to evaluate the condition of the heart valves.
Prevention strategies, such as early diagnosis and prompt treatment of streptococcal throat infections with appropriate antibiotics, are essential to prevent the development and progression of RHD. It is important for individuals with RHD to seek medical care from qualified healthcare professionals, follow prescribed treatment plans, and adopt a healthy lifestyle to manage the condition effectively.
- Degenerative Valve Disease:
Degenerative valve disease refers to the deterioration of heart valves over time, usually due to age-related changes or acquired conditions. It primarily affects the aortic and mitral valves. In India, it is becoming rather prevalent.
Symptoms:
- Shortness of breath: As the valve becomes narrow or blood leaks through the valve, the heart’s ability to pump blood efficiently is compromised, leading to shortness of breath, especially during exertion or physical activity.
- Chest pain or discomfort: Some individuals may experience chest pain or discomfort, typically described as a tightness or pressure in the chest. This symptom is often triggered by physical activity or emotional stress.
- Fatigue: Feeling excessively tired or lacking energy is a common symptom of degenerative valve disease. The reduced cardiac output resulting from impaired valve function can contribute to fatigue.
- Heart palpitations: Irregular or rapid heartbeats, known as palpitations, may occur in individuals with degenerative valve disease. Palpitations can be accompanied by dizziness or a feeling of lightheadedness.
- Fainting or near-fainting episodes: In advanced stages of degenerative valve disease, individuals may experience episodes of fainting or nearly fainting, known as syncope. This symptom arises due to inadequate blood flow to the brain.
Treatment:
- Medications: Medications are primarily used to manage symptoms and improve the overall function of the heart.
- Valve repair or replacement: When the valve damage becomes severe and symptoms are significantly impacting a person’s quality of life, valve repair or replacement surgery may be necessary. The choice between repair and replacement depends on several factors, including the extent of valve damage and the overall health of the patient.
- Transcatheter aortic valve replacement (TAVR): In recent years, minimally invasive procedures such as TAVR have emerged as an alternative to open-heart surgery for select patients. TAVR involves replacing the damaged aortic valve with a new prosthetic valve through a catheter inserted from a small cut in the leg rather than making a big incision in chest.
- Regular monitoring and follow-up: Individuals with degenerative valve disease require regular follow-up appointments with a cardiologist to monitor the progression of the disease, assess valve function, and adjust treatment as necessary.
- Healthy lifestyle habits: Adopting a heart-healthy lifestyle is beneficial for individuals with degenerative valve disease. This includes regular exercise, a balanced diet, smoking cessation, and managing underlying conditions such as high blood pressure and diabetes.
It is essential for individuals with degenerative valve disease to work closely with their healthcare providers to determine the most appropriate treatment plan based on their specific condition and overall health.
Q. Can I do anything to prevent my body from developing a valve disease?
A. While certain valve diseases may have genetic or congenital causes that cannot be prevented, there are steps individuals can take to reduce the risk or delay the onset of valve disease. Here are some preventive measures that can be taken to help ensure the same:
- Good oral hygiene: Poor oral health and untreated dental infections can lead to the spread of bacteria in the bloodstream, potentially affecting heart valves. Maintaining good oral hygiene practices, including regular brushing, flossing, and routine dental check-ups, can help reduce the risk of bacterial infections and their potential impact on the heart.
- Regular medical check-ups: Regular health check-ups can help identify any underlying risk factors or early signs of valve disease. It is especially important for individuals with a family history of valve disease or other heart conditions to undergo routine screenings and assessments.
- Healthy lifestyle choices: Adopting a healthy lifestyle can contribute to overall heart health and reduce the risk of developing valve disease. This includes:
a. Balanced diet: Consuming a nutritious diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy products can support heart health and help prevent conditions that can lead to valve diseases, such as high blood pressure and obesity.
b. Regular exercise: Engaging in regular physical activity, such as brisk walking, jogging, cycling, or swimming, can strengthen the heart and improve cardiovascular fitness. Aim for at least 150 minutes of moderate-intensity aerobic exercise per week.
c. Smoking cessation: Smoking is a major risk factor for heart disease, including valve disease. Quitting smoking and avoiding exposure to secondhand smoke can significantly reduce the risk of developing valve disease and other heart conditions.
d. Limiting alcohol consumption: Excessive alcohol consumption can have adverse effects on heart health. It is advisable to limit alcohol intake.
- Manage underlying conditions: Certain medical conditions, such as high blood pressure, diabetes, and elevated cholesterol levels, can increase the risk of developing valve disease. It is important to manage these conditions effectively through regular medical care, adherence to prescribed medications, and lifestyle modifications.
- Stress management: Chronic stress can contribute to various cardiovascular conditions. Practicing stress management techniques, such as meditation, deep breathing exercises, yoga, or engaging in hobbies and activities that promote relaxation, can support heart health.
Remember that while these preventive measures can reduce the risk of developing valve disease, they may not completely eliminate the possibility. It is crucial to consult with a well qualified cardiologist or cardiac surgeon for personalized advice and appropriate management of individual health conditions.
Getting the appropriate medical treatment and care is crucial to avoid any associated medical complications.
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