DR. C’S JOURNAL: WHAT IS VALVULAR HEART DISEASE?

I continue to be amazed by-and grateful for -the astounding collection of miracles that is the human body. Each element is durable if properly maintained and potentially provides us with a long and healthy life. The heart Valves are a part this wonderful orchestra, opening and closing about 2 billion times in a full lifetime.

It is possible to visually appreciate our heart and it’s valves, but millions of other microscopic-nanoscopic-little protein machines are also opening, closing, twisting and folding anonymously, allowing us to live and move.

Now is a particularly good time to talk about the heart valves because imaging devices are available to detect, and surgical techniques are at hand to treat, the common problems that develop in the course of optimally guiding our blood through the heart, into 2 separate circuits, the pulmonary, and the systemic. Life can be defined as an island of order in a sea of chaos. Energy is required to allow this island to fend off dissolution. The energy is used to continually maintain the integrity of our cells, the island in this metaphor, and keep entropy at bay.  Myriads of biochemical mechanisms direct this repair. Sleep, diet, and exercise aid in the mending.

We use our bodies in the daytime, and at night switch to a cleansing and repairing function, sleep.  Diet, and our resident microbiome, provide the materials for this restoration. Exercise helps utilize excessive nutrients, and directs our metabolism towards regeneration and repair.

Some valvular problems are present at birth because of defective development. Bicuspid aortic valves and mitral prolapse are examples. Hypertension places a strain on the entire system. Type two diabetes can cause inflammation and abnormal deposits in the valves. A variety of biochemical pathways active during the formation of the heart can go awry and fail to maintain the neatly layered deposits of collagen, proteoglycans and elastic tissue that forms the basis of the valves, and the endothelial cells that line them.

Tobacco smoke, which harms in so many other ways, can also damage the heart valves, as can infections, which sometimes grow on the heart valves themselves. Symptoms of heart valve disease include abnormal sounds that your doctor can hear, or the the presence of fatigue, shortness of breath, swelling of the ankles, and dizziness, which are common symptoms of cardiac malfunction. Unusual chest pains, particularly with mitral prolapse, and irregular heartbeat can also be present.

Replacement of some valves via a catheter inserted in an artery is one of the recent advances in treatment of Valvular heart disease.

Ultrasound is particularly useful in diagnosing valvular heart disease, but a whole cafeteria of diagnostic tests are available to doctors these days.
Please refer to the following Mayo clinic article for more information.

—Dr. C

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