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Can heart valve disease be treated with medications?

Can heart valve disease be treated with medications?

Introduction

More than one fourth of the global rheumatic heart disease cases are from India. This is one of the most common heart valve disease and most people are unaware of the condition until it progresses to an advanced stage. Let us take a look at important information about the condition.

What is heart valve disease treatment?

Treatment of heart valve disease will depend on the actual or specific problem, severity, observed symptoms, and patient’s overall health. It is to be noted that heart valve disease may affect one or more than one of the four valves. The four different valves are aortic, mitral, tricuspid, and pulmonary valves. Different treatment options typically used for heart valve disease include the following:

  1. Changes in lifestyle

This is ideal for cases that are mild or when there is a need for supportive care, when other treatments are ongoing.  This includes switching to a heart healthy diet, takin part in routine exercise or physical activity, and controlling other risk factors. For instance, keeping blood pressure, cholesterol and blood sugar levels in control. 

  1. Medications

This is to manage symptoms, ensure that there are no future complications, and to control conditions inked with valve disease. Medicines usually recommended include diuretics, anticoagulants, beta-blockers, ACE inhibitors and calcium channel blockers. 

  1. Valve repair

In a high percentage of cases, valve repair may be surgically undertaken. This includes mitral valve repair where the mitral valve is reconstructed through annuloplasty, chordae tendineae repair, and tricuspid valve repair.

  1. Valve replacement

This is for a relatively lesser number of cases where repair will not be effective enough for recovery. This includes replacement with mechanical valves made from durable materials like metal or carbon. This may also include use of biological tissue valves from animal tissues or from human donor tissue. Another method is transcatheter aortic valve replacement, for insertion of new valve via a catheter. 

  1. Management  

It will also be necessary to manage complications from the conditions. For instance, arrhythmias will have to be managed through cardioversion or ablation. Similarly, medicines, and changes in lifestyle may be necessary to deal with heart failure. It may sometimes also need advanced options like placement of a ventricular assist device.

What are the common valvular heart disease symptoms?

The symptoms of heart valve disease are not always the same, and will depend on the affected heart valve, apart from severity of the condition. However, some symptoms can be considered as typical and lined with different types of valvular heart disease, as listed below:

  1. Aortic valve disease

When there is aortic stenosis, the following symptoms may be observed:

  •       Difficulty breathing
  •       Pain in the chest.
  •       Overall tiredness.  
  •       Dizzy feelings. 
  •       Heart murmurs. 

Wen there is aortic regurgitation, the following symptoms may be observed:

  •       Difficulty breathing. 
  •       Irregular heartbeats.
  •       Overall tiredness. 
  •       Fluid buildup in the feet.
  1. Mitral valve disease

When there is mitral stenosis, the following symptoms may be experienced:

  •       Difficulty breathing. 
  •       Overall tiredness. 
  •       Irregular heartbeats.
  •       Continuous cough.
  •       Blood in sputum.

When there is mitral regurgitation, the following symptoms may be experienced:

  •       Difficulty breathing. 
  •       Overall tiredness. 
  •       Irregular heartbeats.
  •       Fluid buildup in the feet.
  1. Tricuspid valve disease

When there is tricuspid stenosis, the following symptoms may be observed:

  •       Swelling in the legs.
  •       Some discomfort in the abdomen. 
  •       Difficulty breathing.

When there is tricuspid regurgitation, the following symptoms may be experienced:

  •       Swelling in the legs.
  •       Overall tiredness. 
  •       Difficulty breathing. 
  1. Pulmonary valve disease

When there is pulmonary stenosis, the following symptoms may be experienced:

  •       Difficulty breathing. 
  •       Overall tiredness. 
  •       Pain in the chest.

When there is pulmonary regurgitation, the following symptoms may be experienced:

  •     Difficulty breathing. 
  •     Overall tiredness. 
  •     Swelling in the legs.

What is WHO classification of heart disease in pregnancy?

The World Health Organization relies on a system to classify heart disease in pregnancy based on the severity and impact. This is to manage the condition better among pregnant women, especially those with existing heart conditions or heart valve disease.

Different WHO classifications

Class I: No Increased Risk – this refers to pregnant women with heart conditions who do not have any increased risk of complications.  Examples of conditions in this category are asymptomatic congenital heart disease, and mild mitral valve prolapse.

Class II: Mildly Increased Risk – this refers to pregnant women with some increased risk of complications that can be managed. Examples include moderate aortic stenosis/regurgitation, stable mitral stenosis and controlled atrial septal defect.

Class III: Significantly Increased Risk – this refers to pregnant women with a significant risk of complications. This may impact both the mother and the fetus and require special care. Examples include severe aortic stenosis/regurgitation, severe mitral stenosis, uncontrolled atrial fibrillation, ventricular arrhythmias and heart failure.

Class IV: Very High Risk – this refers to pregnant women with a very high risk of severe complications. This affects cardiac function and demands specialized care from a multidisciplinary team of specialists. Examples include severe heart failure, severe left ventricular dysfunction, severe pulmonary hypertension, right heart failure, and complex congenital heart defects. Severe systemic diseases also belong to this category, like advanced rheumatic heart disease or serious valve disease.

Is it possible to reverse heart disease?

It may not be possible to completely reverse heart disease, but considerable improvement can be achieved. The extent of improvement and management depends on the type and the actual stage or progression of the disease. These complex factors determine the extent of reversal. Heart valve disease can only be managed to prevent complications, and to mitigate the outcomes through interventions. Here is a quick outline of managing heart disease:

  • Changes to lifestyle – this includes a heart-healthy diet to reduce risk factors such as high cholesterol and high blood pressure. Regular physical activity is necessary to improve cardiovascular health as it strengthens the heart muscle and improves blood circulation. Other changes include weight management, quitting smoking, and cutting down on alcohol intake.
  • Medicines – such as statins to lower cholesterol levels; ACE inhibitors, beta-blockers, and calcium channel blockers to control high blood pressure. Other medicines include aspirin to prevent blood clots, and medicines for controlling blood sugar levels.
  • Procedures – such as angioplasty and stenting to open blocked coronary arteries and keep it open. Other surgeries include Coronary Artery Bypass Grafting to bypass blocked arteries.  Heart valve disease related surgeries include valve repair or replacement.
October 25, 2024 Cardiovascular Disease , , , , ,