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How I Live with Heart Valve Disease Sarah Howell ABOUT the BRITISH HEART FOUNDATION CONTENTS

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How I Live with Heart Valve Disease Sarah Howell ABOUT the BRITISH HEART FOUNDATION CONTENTS How I live with Heart Valve Disease Sarah Howell ABOUT THE BRITISH HEART FOUNDATION CONTENTS As the nation’s heart charity, we’ve been funding About this booklet 02 cutting-edge research that has made a big di erence What are the heart valves? 03 to people’s lives. What is heart valve disease? 06 What are the symptoms of heart valve disease? 10 But the landscape of heart and circulatory disease What causes heart valve disease? 12 is changing. More people survive a heart attack than How is heart valve disease diagnosed? 18 ever before, and that means more people are now What happens after my diagnosis? 24 living with heart and circulatory disease and need What are the treatments for heart valve disease? 26 our help. Heart valve surgery 30 What sort of replacement valves are used? 34 Our research is powered by your support. Every What are the bene ts and risks of valve surgery? 38 pound raised, every minute of your time, and every Other techniques for valve replacement or repair 43 donation to our shops will help make a di erence to Heart valve disease and pregnancy 46 people’s lives. Anticoagulants 48 If you would like to make a donation, please: What is endocarditis? 54 Living with heart valve disease 59 • call our donation hotline on 0300 330 3322 Heart attack? The symptoms… and what to do 64 • visit bhf.org.uk/donate or Cardiac arrest? The symptoms… and what to do 66 For more information 73 • post it to us at BHF Customer Services, Lyndon Place, Index 78 2096 Coventry Road, Birmingham B26 3YU. Have your say 80 For more information, see bhf.org.uk Find out more about our life saving heart research at bhf.org.uk/research ABOUT THIS BOOKLET WHAT ARE THE HEART VALVES? 03 This booklet is for people who have a problem with Your heart is a muscle that pumps blood around one or more of their heart valves. It also provides your body. It’s made up of four connected chambers useful information for family and friends. It explains: (sections). These are the left atrium, the right atrium, the left ventricle and the right ventricle. • what heart valve disease is • how heart valve disease is diagnosed There are four valves in your heart, guarding the exits • what types of treatment are available, and of the four chambers. They are called the mitral, aortic, • what you can do to help yourself. tricuspid and pulmonary valves. This booklet doesn’t replace the advice your doctor or cardiologist (heart specialist) may give you, but it should help you to understand what they tell you. right atrium left atrium pulmonary mitral valve valve tricuspid valve aortic valve right ventricle left ventricle 04 05 How does my blood ow? Blood owing through the heart Each heart valve has either two or three ‘lea ets’ or ‘cusps’. These are very small aps of skin which cover To the body the valve. The aps open and close to let blood ow through in the correct direction, and to stop it from From owing backwards. the body This is the journey that blood takes through your To the heart and around your body: lungs To the • Blood containing oxygen arrives from your lungs lungs into the left atrium of your heart, and passes From From through the mitral valve into the left ventricle. the the lungs • It then passes back out of the heart through the lungs aortic valve, to provide oxygen- lled blood around your body. tricuspid valve mitral valve • Once this blood has travelled around your body, providing oxygen and nutrients to your cells, it pulmonary returns to the heart. It arrives into the right atrium. valve aortic valve • Next, it passes through the tricuspid valve into the right ventricle. • Finally, the blood leaves the heart through the pulmonary valve, travelling back to the lungs From the body To the body where it takes in more oxygen. WHAT IS HEART VALVE DISEASE? 07 The valves in your heart can become diseased or If you have valve regurgitation, your heart will have damaged for di erent reasons (see pages 12-15). to work extra hard to pump enough blood forward It may be something that you’re born with, or that against the blood that leaks back through the valve. develops during your life. The blood behind an a ected valve will be under Problems with your heart valves can make it di cult increased pressure too. This is called ‘back pressure’, for blood to ow through your heart properly. There and it can cause a build-up of uid in your lungs, are two ways this can happen: ankles or legs, depending on the valve a ected. • The valve doesn’t open fully or it becomes sti . This is called valve stenosis. It means that the valve becomes narrow, so blood can't ow through as easily as it would through a healthy valve. • The valve doesn’t close properly, which causes some blood to leak backwards. This is called valve regurgitation or valve incompetence. Doctors may call this a ‘leaky valve’. Both stenosis and regurgitation can put extra strain on your heart. If you have valve stenosis, the sti , narrowed valve can limit the ow of blood, so your heart will have to pump harder to force blood through the valve. 08 LEADING THE FIGHT… against heart valve disease The most common problems that people have are di erent for each valve: The BHF is the UK's largest independent funder of research into heart and circulatory disease. Valve Most common problem Some highlights of our research into heart valve Mitral The lea ets ( aps) stretch and become ‘ oppy’, disease include: leading to blood leaking backwards (regurgitation). Or, the valve becomes deformed, causing it to leak Developing new replacement heart valves out blood. This is mitral valve prolapse – it can cause 1 of materials that last longer and improve the a heart murmur (see page 18), but will not usually quality of life for those who need them. These need treatment. valves could help reduce the number of repeat Aortic Becomes sti and narrow, making it di cult for surgeries and avoid the need for anticoagulants. blood to leave the heart. Tricuspid Problems are less common than the mitral or Researching how the heart valves form when aortic valves. 2 a baby is in the womb, to identify why some Problems with the left side of the heart can cause the babies are born with heart valve abnormalities, tricuspid valve to leak. and understand why problems related to these Pulmonary Problems are rare, and usually caused by congenital abnormalities can develop later in life. defects (problems a baby develops while in their mother’s womb). Our life saving research is powered by your support. If you’d like to make a donation, please see the inside front cover for more details. For more information on the BHF's research successes, visit bhf.org.uk/research WHAT ARE THE SYMPTOMS OF HEART VALVE DISEASE? 11 The symptoms of heart valve disease vary, depending Abnormal heart rhythms (atrial brillation) on which valve is a ected and how badly it has been Your heart’s normal pumping action is controlled by damaged. People with mild heart valve disease (see tiny electrical messages, sent out to make sure your pages 22-23) might not notice any symptoms, or may heart pumps blood around your body in a normal, have very few symptoms. regular rhythm. But others can experience several common symptoms, Some people with heart valve disease may develop an caused by problems related to heart valve disease: abnormal heart rhythm called atrial brillation. This is when di erent places in and around the atria (the two Problem Symptom upper chambers of the heart – see page 03) re o electrical impulses in an uncoordinated, disorganised Increased strain on the heart • Tiredness way. This makes the atria twitch or quiver, causing an (see pages 06-07) • Palpitations (uncomfortable pounding in the chest) irregular and sometimes fast heart rate, or pulse. The symptoms of atrial brillation may include ‘Back pressure’ (see page 07) • Shortness of breath causing build-up of uid in the • Swelling of ankles and legs palpitations, dizziness or light-headedness, and lungs and legs shortness of breath. Blood not owing correctly • Chest pain The treatment for atrial brillation may be one or to the coronary arteries (the more of the medicines listed on page 28, and might blood vessels which supply the heart muscle with oxygen) include an anticoagulant medicine (see pages 48-53). Forward ow of blood severely • Dizziness obstructed, blocking enough • Fainting blood from reaching the brain For more information about atrial fibrillation, its symptoms and treatments, see our booklet Atrial fibrillation. WHAT CAUSES HEART VALVE DISEASE? 13 The main causes of heart valve disease are: Congenital heart disease A congenital condition is a condition which develops ageing of the heart • when a baby is in the womb. Some people are born • congenital heart disease (being born with an with an abnormal heart valve or valves. abnormal heart valve or valves) • coronary heart disease Most of these people will never experience any symptoms. But for some people, their condition can • cardiomyopathy get worse over time. The valve may become sti or • a previous infection with endocarditis, and leaky and require treatment. rheumatic fever. • For example, a child could be born with a bicuspid Ageing of the heart aortic valve, with two cusps ( aps) on their aortic As you get older, your heart valves can become thicker valve, rather than the usual three.
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