You're driving down the highway. The road is congested, but it's moving steadily. And then you see something ahead, a construction worker forcing traffic to slow down or stop.
Your heart valves play a similar role as a traffic controller, regulating the flow of blood by opening and closing, millions of times each year. The primary function of these valves is to ensure blood flows in only one direction—toward your lungs. Your lungs are where blood gets oxygenated, so it can be sent out to the rest of your body.
"When heart valves fail, the flow of blood through the heart is disrupted. So, you can have varying problems, most seriously heart failure," says Maureen Julien, MSN, CRNP, lead nurse practitioner for interventional cardiology at Penn Medicine.
To get a better picture of the impact heart valve disease has on your body, we'll look at how blood circulates through your heart.
The Road Map
First, let's outline the route. Your heart is comprised of four valves: pulmonary, aortic, tricuspid and mitral, each with its own flaps that open and close with each heartbeat. That familiar "lub-dub" sound your heart makes is your heart valves regulating traffic, or opening and closing to move blood through your heart.
The flow of blood is only as good as the traffic controllers, conditions and flow of traffic. However, if the valves aren't functioning properly, you can experience a range of symptoms, including:
- Shortness of breath
- Chest pain
- Swelling of the legs
- Unexpected weight gain
Let's take a look at three of the main issues that happen with heart valves:
- Stenosis: an over-restriction in blood flow
- Regurgitation: blood leaks through or flows backwards
- Atresia: occurs when valves are not properly formed, often at birth
Stenosis: An over-restriction in blood flowValve stenosis occurs when a valve fails to open properly. The flaps of the valve—also called leaflets—may be too stiff, too thick, or even fused together.
|Aortic stenosis obstructs normal blood flow in the heart|
This happens for a variety of reasons. “Sometimes, leaflets just degenerate. The leaflets can be attacked by diseases like rheumatic heart failure if they have rheumatic fever as a child,” explains Maureen.
“A valve can also become calcified, which sometimes happens just with age,” she adds. Valve calcification occurs when calcium in the blood builds up on heart valves. With valve stenosis, the body gets less oxygenated blood, which if left untreated can lead to heart failure.
Regurgitation: Blood leaking through or flowing backwardsValve regurgitation is also referred to as a leaky heart valve. Unlike in stenosis, the valve opens up completely but doesn’t close tightly enough. Blood may leak or backflow through the valve after closing.
Leaky valves are the equivalent of a traffic controller slacking on the job. Although the traffic controller is working, he’s not helping you get from point A to point B. So, a rogue driver may get a crazy idea to back up on the shoulder looking for another exit ramp.
“That annulus, or the circle that holds the heart valve, can dilate if you have an enlarged heart, for example,” Maureen says. “Sometimes, that shape can change. That change and dilation can cause distortion, so the valve does not properly close.”
When valve regurgitation occurs, the supply of oxygenated blood moving through the heart is reduced. This makes the heart work harder, which may produce fatigue or shortness of breath.
Atresia: Valves that are not properly formed
The last type of heart valve disease called atresia can actually result in stenosis or regurgitation. Atresia occurs if a heart valve isn’t formed properly, often at birth.
Improper formation of valves, which usually occurs with pulmonary or aortic valves, may include:
- Too few leaflets or flaps
- Incorrect valve size or shape
- No opening to allow blood to flow through properly
“A lot of times, those valves don’t cause you problems even though you were born with it. Until you become an adult,” says Maureen.
Regulating Traffic FlowIf you feel like you’re headed for a major traffic incident, it’s important to get the heart valve issue diagnosed and monitor the condition. Ultimately, to prevent a major traffic incident, Maureen recommends talking with your physician. “I think it’s important to keep open lines of communication with your doctor. If you’re feeling a change in your symptoms and something is different, then let them know,” she says.
Do you have questions about heart valve disease?
Penn's Heart Valve Disease Program is the largest in region, with more valve surgeries performed than any other hospital in Pennsylvania.