Articles on Medical Diseases and Conditions

Tag: Valve Problems

  • Pulmonary Valve Problems

    The pulmonary valve controls the blood ?ow between the right ventri- cle and the pulmonary artery leading into the lungs . Although disease is rare, the pulmonary valve can develop regurgitation (backward leakage) or stenosis (narrowing).

    Pulmonary Regurgitation

    Pulmonary regurgitation is a condition in which some blood is allowed to leak back from the pulmonary artery into the right ventricle. It is usually caused by congenital (present since birth) disease or pulmonary hypertension (high blood pressure in the lungs and right side of the heart). It is often associated with congenital heart disease affecting other parts of the heart. Very rarely, infective endocarditis (see page 192) damages the valve.
    Many people with some pulmonary regurgitation do not have symp- toms of the condition. Your doctor will monitor your heart regularly to ensure that the right ventricle is not becoming strained or enlarged. You will probably not need to limit your physical activities. If you have a valve that has been malformed since birth, you are at greater risk of infective endocarditis and may need to take antibiotics before dental or surgical procedures (see page 194).
    If the regurgitation becomes serious, it causes the right ventricle to start to fail. Then you may experience symptoms such as shortness of breath, especially during exercise; fatigue; chest pain; or leg swelling. Arrhythmias may occur. Ask your doctor about any exercise restrictions. You may require surgery to repair or replace the valve .

    Pulmonary Stenosis

    Pulmonary stenosis is a condition in which the pulmonary valve (or the artery just beyond the valve) is narrowed, reducing the ?ow of blood into the lungs. It is usually present at birth and may progress in childhood or not until later in life. If it occurs later in life, it may have been caused by rheumatic fever , congenital heart disease, or infective endocarditis.
    Pulmonary stenosis can be very mild or moderate, and it usually does not cause severe symptoms. Your doctor will check your heart regularly, watching for signs of strain on your right ventricle. You may not need to limit your physical activity, but you are at greater risk of infective endocarditis, so you will need to take antibiotics before having some dental and surgical procedures .
    If the condition is severe, it may cause symptoms such as shortness of breath, especially during exercise; fatigue; chest pain; or rarely, a bluish skin tone. Severe stenosis could cause life-threatening failure of the right ventricle. Sometimes surgery to repair the valve is done early, dur- ing the preschool years of a child’s life. In an older person, balloon valvuloplasty is usually needed to open the valve, or rarely, valve replacement  may be necessary.

  • Tricuspid Valve Problems

    The tricuspid valve is on the right side of the heart, regulating the blood ?ow between the right atrium and the right ventricle. Disease in this valve is fairly rare. However, regurgitation (backward leakage of blood through the valve) may occur as the only valve problem or may occur with other problems. Stenosis (narrowing of the valve opening) is most often congenital (from birth) and rarely occurs in adults.

    Tricuspid Regurgitation

    If the tricuspid valve fails to close fully, blood leaks back (regurgitates) from the right ventricle into the right atrium. Instead of the blood mov- ing forward through the right ventricle to the lungs to pick up oxygen, it backs into the major veins. It most often occurs if the right ventricle becomes enlarged or stiffened from another disorder, such as high blood pressure within the lungs and right side of the heart (pulmonary hypertension). Tricuspid regurgitation may also result from infective endocarditis , rheumatic fever , or car- diomyopathy .
    A person with tricuspid regurgitation usually does not have any symptoms, or the symptoms may be mild enough to live with for years, and no treatment is necessary. If you have high blood pressure in the lungs, as well as tricuspid regurgitation, you may develop symptoms of heart failure such as swelling in the stomach, liver, feet, and ankles; weakness and fatigue; and decreased urine output. Treatment with med- ications such as diuretics may relieve the symptoms. If tricuspid regur- gitation is due to pulmonary hypertension, calcium channel blockers may be prescribed. In some people, surgery to replace the tricuspid valve  may be necessary.
    If you have tricuspid regurgitation because of an abnormal valve, you are at increased risk of infective endocarditis, and you will need to take antibiotics before some dental and surgical procedures.

    Tricuspid Stenosis

    If the tricuspid valve is narrowed or blocked, blood ?ow from the right atrium to the right ventricle slows down. The atrium may become enlarged and the blood ?ow to the right ventricle may be impaired. Tricuspid stenosis, which is rare, may be congenital (from birth) or the result of rheumatic fever. If rheumatic fever is the cause, other valves of the heart are usually involved.
    Generally, the only symptoms of tricuspid stenosis are fatigue and the pain pressure in the liver (which you are likely to feel in your upper right abdomen). Often these symptoms, as well as some shortness of breath and ?uid retention, are caused by disease in another valve. Treat- ment is likely to focus on the other valves. If your tricuspid valve is severely damaged, surgery is possible. As with other valve disorders, you are at increased risk of infective endocarditis, and your doctor may advise you to take antibiotics before some dental and surgical procedures.