Heart valve diseases can manifest as stenosis, insufficiency, or a combination of both. The valves on the left side of the heart are usually more affected because they are exposed to higher pressure from the left ventricle. The type of heart valve disease determines how it impacts the heart: stenosis causes increased pressure and thickening of the heart muscle, while insufficiency results in extra volume and dilation of the heart chambers. This section provides an overview of different valve diseases and basic principles of physical examination and diagnostics, especially since listening to the heart can reveal signs of valve issues. The symptoms and treatments for specific valve diseases are discussed in their respective sections.
General Symptoms of Heart Valve Disease (Stenosis and Insufficiency):
1. Shortness of breath (dyspnea): Both valve stenosis and insufficiency can make it difficult for the heart to pump oxygen-rich blood to the body, leading to difficulty breathing, especially during physical activity.
2. Chest pain (angina): For both conditions, the heart may not receive enough blood, causing pain or discomfort in the chest, particularly during exertion. This is more common in valve stenosis but can also appear in severe insufficiency cases.
3. Dizziness or fainting (syncope): A reduced blood flow to the brain, common in severe stenosis, may cause dizziness or fainting. Although less common with valve insufficiency, it can occur if the heart fails to maintain proper circulation.
4. Fatigue: Both stenosis and insufficiency may lead to general tiredness, as the heart struggles to meet the body’s demands for blood and oxygen.
5. Swelling in the legs or abdomen: In more advanced stages of valve disease (both stenosis and insufficiency), the heart’s inability to pump efficiently can cause fluid buildup, leading to swelling in the lower body, especially in the legs or abdomen.
6. Heart palpitations: In cases of valve insufficiency, the heart may beat irregularly or faster to compensate for the backflow of blood, which can be felt as palpitations.
Key Differences in Symptoms between Stenosis and Insufficiency:
– Stenosis (narrowing of the valve) primarily leads to pressure overload. As a result, it tends to cause symptoms related to reduced blood flow out of the heart, such as shortness of breath, chest pain, and fainting, especially during physical exertion.
– Insufficiency (leakage of the valve) causes volume overload, which stretches the heart chambers. This often leads to symptoms like fatigue, palpitations, and, in later stages, signs of heart failure such as swelling in the legs and shortness of breath at rest.
Putting the Symptoms in Context:
Both stenosis and insufficiency can lead to similar symptoms, but they develop for different reasons. In stenosis, the heart has to work harder to push blood through a narrowed valve, while in insufficiency, the heart is constantly pumping extra blood due to the backflow.
As a result, patients may feel tired or short of breath, have chest pain, or even faint, especially during activity. These conditions can be silent for years, with no symptoms until the heart becomes significantly stressed. Therefore, regular check-ups and early diagnosis are key to managing valve diseases before they cause serious complications, such as heart failure.
