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Valvular heart diseases

Valvular heart diseases Are any disease process involving one or more of the four valves of the heart the aortic and bicuspid valves on the left side of the heart and the pulmonary and tricuspid valves on the right side of the heart.

 

Aortic and mitral valve disorders:

 

  • stenosis
  • Regurgitation

 

Symptoms:

 

1) Mitral stenosis:

 

  • Heart failure symptoms, such as dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea
  • Palpitations
  • Chest pain
  • Hemoptysis
  • Thromboembolism
  • Ascites and edema (if right-sided heart failure develops)
  • Symptoms increase with exercise and pregnancy

 

2) Mitral regurgitation:

 

  • Heart failure symptoms, such as dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea
  • Palpitations
  • Angina pectoris
  • In acute cases: cyanosis and circulatory shock

 

3) Aortic stenosis:

 

  • Heart failure symptoms, such as dyspnea on exertion (most frequent-symptom), orthopnea and paroxysmal nocturnal dyspnea
  • Angina pectoris
  •  Syncope, usually exertional

 

4) Aortic regurgitation:

 

  • Heart failure symptoms, such as dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea
  • Palpitations
  • Angina pectoris

 

Treatments:

 

1) Mitral stenosis:

 

  • No therapy is required for asymptomatic patients
  • Diuretics for any pulmonary congestion 
  • surgery is recommended If the stenosis is severe 

 

2) Mitral regurgitation:

 

  • Afterload reduction with vasodilators 
  • Any hypertension is treated aggressively e.g. by diuretics and low sodium diet 
  • digoxin 
  • Antiarrhythmics 
  • Surgery by either mitral valve repair or mitral valve replacement

 

3) Aortic stenosis:

 

  • No treatment in asymptomatic patients
  • If symptomatic, treated with aortic valve replacement surgery

 

4) Aortic regurgitation:

 

  • low sodium diet
  • diuretics
  • vasodilators hydralazine  or prazosin digoxin
  • ACE inhibitors angiotensin II receptor antagonists
  • calcium 
  • Aortic valve replacement in symptomatic patients
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