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Valvular heart disease

Valvular heart disease
Classification and external resources
Specialty Cardiology
ICD-10 I05-I08, I34-I37, Q22-Q23
ICD-9-CM 394-396, 424, 746
MeSH D006349
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Valvular heart disease is any disease process involving one or more of the four valves of the heart (the aortic and mitral valves on the left and the pulmonary and tricuspid valves on the right). These conditions occur largely as a consequence of aging, but may also be the result of congenital (inborn) abnormalities or specific disease or physiologic processes including rheumatic heart disease and pregnancy.

Anatomically, the valves are part of the dense connective tissue of the heart known as the cardiac skeleton and are responsible for the regulation of blood flow through the heart and great vessels. Valve failure or dysfunction can result in diminished heart functionality, though the particular consequences are dependent on the type and severity of valvular disease. Treatment of damaged valves may involve medication alone, but often involves surgical valve repair (valvuloplasty) or replacement (insertion of an artificial heart valve).

Stenosis and Insufficiency/Regurgitation

Stenosis and insufficiency/regurgitation represent the dominant functional and anatomic consequences associated with valvular heart disease. Irrespective of disease process, alterations to the valve occur that produce one or a combination of these conditions. Insufficiency and regurgitation are synonymous terms that describe an inability of the valve to prevent backflow of blood as leaflets of the valve fail to join (coaptation) correctly. Stenosis is characterized by a narrowing of the valvular orifice that prevents adequate outflow of blood. Stenosis can also result in insufficiency if thickening of the annulus or leaflets results in inappropriate leaf closure.

Aortic and mitral valve disease are termed left heart diseases. Diseases of these valves are more prevalent than disease of the pulmonary or tricuspid valve due to the higher pressures the left heart experiences.

Stenosis of the aortic valve is characterized by a thickening of the valvular annulus or leaflets that limits the ability of blood to be ejected from the left ventricle into the aorta. It is typically the result of aging, occurring in 2.8% of the population over 75 years of age and represents the most common cause of outflow obstruction in the left ventricle. Stenosis is typically the result of valvular calcification, but may be the result of a congenitally malformed bicuspid aortic valve. This defect is characterized by the presence of only two valve leaflets and affects up to 1% of the population, making it one of the most common cardiac abnormalities. It may occur in isolation or in concert with other cardiac anomalies.


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