Why heart valve problems and shortness of breath?
Heart valve problems and shortness of breath (dyspnea) often occur together. As a matter of fact, trouble breathing is one of the most common symptoms of heart valve disease. It is also one of the most frightening and disturbing.
Feeling short of breath after strenuous physical exercise or activity is normal. But, when light activities cause breathing difficulties and/or one experiences unprovoked dyspnea, heart valve problems could be the underlying cause.
Dyspnea from valve problems often presents as shortness of breath with exertion. Many people also experience shortness of breath at night or shortness of breath when lying flat. It can feel like you’re not getting enough air and need to breath in more (air hunger) or breathing may just be uncomfortable. In serious cases, it may feel like suffocation. These are telltale signs of heart valve disease.
How can heart valve problems cause shortness of breath?
There are two main types of heart valve problems or diseases. The first one is valvular regurgitation (aka heart valve insufficiency or incompetence – a leaky heart valve) and the second is valvular stenosis. Both can cause shortness of breath, along with a variety of other symptoms. Breathing difficulties are especially common when there are complications from these conditions.
With valve regurgitation, one or more heart valves do not close properly during the cardiac cycle. This allows blood to leak backward or regurgitate into the chamber/s that it came from when the heart beats. Dyspnea may occur because the heart must work harder to supply the body with oxygenated blood. It also occurs when the lungs become congested with fluid (pulmonary edema).
In valvular stenosis, shortness of breath may occur for similar reasons to heart valve regurgitation. But, dysfunction occurs because the affected valve is stiff or fused and has a narrow opening. The narrowed (stenotic) opening reduces the amount of blood that can flow through it, making the heart work harder to pump blood. Heart failure is a complication of heart valve stenosis.
Regurgitation and stenosis can affect the mitral valve, the pulmonary valve, the tricuspid valve, and the aortic valve. These are the four functional valves of the heart, which serve to regulate blood flow through the organ and its great vessels. When one or more of the valves fails or functions abnormally, then heart function diminishes and dangerous symptoms and complications can arise.
Who is at risk for heart valve problems and shortness of breath?
Some individuals are at higher risk for heart valve problems and shortness of breath, particularly adults over 60 years of age. Heart valve disease in the elderly is a growing problem, in actual fact, as life expectancy continues to increase due to medical advances. Older people have aged heart valves that are thicker and stiffer. This makes them more prone to various types of heart valve disease.
The risk of heart valve problems and dyspnea also increases when a person has a history of heart attacks, rheumatic fever, and infective endocarditis. These conditions can cause serious damage to the valves, resulting in breathing difficulties and complications. Certain medications can have the same effects, specifically pergolide, fenfluramine, and dexfenfluramine, as well as ergotamine.
In addition to the above, having risk factors for coronary artery disease increases the risk of heart valve disease. That is, people who smoke, are sedentary and obese, and/or have a family history of early heart disease are more likely to experience heart valve problems. Having medical conditions such as high blood pressure, high blood cholesterol, and diabetes can increase the risk significantly.
Other conditions that increase the risk of problems with the valves include cardiomyopathy, connective tissue disease, and congenital heart disease. Connective tissue disorders like Marfan syndrome and Ehlers–Danlos syndrome and congenital defects like Ebstein’s anomaly, prolapsing heart valves, and bicuspid aortic valve are associated with heart valve problems that cause shortness of breath.
What are other common symptoms of heart valve problems?
Symptoms of heart valve disease often occur with shortness of breath and heart valve problems. While the symptoms can vary with different types of valvular disease, they tend to be similar. Common symptoms include heart palpitations, chest pain or angina, and coughing. One may also experience heart valve disease symptoms such as fatigue, dizziness, and weakness, and loss of appetite.
In heart valve disease patients with a leaky valve in the heart, there may be leaky heart valve symptoms – anxiety, sweating, and fainting, as well as hemoptysis and cyanosis. There may also be heart failure symptoms such as low exercise tolerance, nocturia, and rapid weight gain caused by edema. Edema may cause swelling of the abdomen and extremities, especially the ankles, legs, and feet.
A heart murmur is a common sign of a leaky heart valve. It may be present with aortic regurgitation, pulmonary regurgitation, tricuspid regurgitation, or mitral regurgitation, which may or may not accompany mitral valve regurgitation symptoms and other symptoms of a heart valve leak. Murmurs can also be present with MVP and problems involving stenosis, such as aortic stenosis.
Some valve diseases occur with other medical conditions that may cause additional symptoms. For example, approximately 40% of patients with a prolapsing mitral valve experience symptoms of dysautonomia. These include panic attacks, depression, and intestinal problems, among others. MVP sufferers with autonomic dysfunction are said to have the mitral valve prolapse syndrome.
How are heart valve disease symptoms treated?
Heart valve symptoms can be treated in different ways. That being said, treating heart valve problems and shortness of breath, chest pain, palpitations, and other disturbing symptoms usually involves taking prescription heart valve medications. Depending on the patient’s specific symptoms, medical condition, and risk factors, one or more drugs may be prescribed for symptomatic relief.
The heart valve medication list for people with heart valve problems includes drugs such as diuretics, vasodilators, blood thinners, and antiarrhythmics. Doctors also prescribe benzodiazepine anxiety medication and beta blockers for mitral valve prolapse and valvular heart disease. In cases of infection with a mitral valve leak or heart valve regurgitation, certain antibiotics may prove helpful.
Getting regular exercise and following a heart healthy diet are other methods of treating the symptoms of heart valve problems. In fact, for many sufferers, following a mitral valve prolapse diet plan significantly reduces heart valve symptoms. Natural remedies like kava, hops, and magnesium can provide relief from symptoms for some individuals, but they aren’t suitable for everyone.
There are numerous treatments available to those living with mitral valve disease, aortic valve disease, and problems affecting the heart’s valves. While many of these treatments can relieve bothersome heart valve symptoms, the best options aim to treat the underlying problem. Thus, every heart valve disease treatment should begin with a professional medical heart valve disease diagnosis.
Can heart valve disease be cured?
In some cases, heart valve diseases can be cured, relieving the symptoms of heart valve disease and improving quality of life and the general prognosis. However, the only way to completely cure heart valve problems is through heart valve surgery to fix the physical problem. This typically involves heart valve repair or heart valve replacement by a cardiothoracic surgeon in a hospital setting.
Open heart surgery is the standard surgical approach for repairing and replacing heart valves. During the procedure, a cardiac surgeon cuts opens the sternum to access to the heart and work on its structures. The heart is stopped and a heart-lung machine temporarily takes over the functions of the heart and lungs during surgery. Open heart surgery recovery can take five to eight weeks.
Minimally invasive heart valve surgery is the alternative to open valve surgery. It is a surgical option where a surgeon repairs or replaces the affected valve/s but accesses the heart in a much less invasive manner. During minimally invasive valve surgery, the doctor makes smaller incisions and does not cut (or only partially cuts) the sternum. This can benefit the patient in several ways.
One of the advantages of minimally invasive surgery is a significantly shorter recovery time. It generally takes between one and four weeks to recover. Patients also experience less pain and scarring, and there is a lower risk of bleeding and infection. Open surgery often provides better access, though, and may offer better overall outcomes for some heart valve problems and shortness of breath.
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