Heart Valves - Causes of Blockage (mitral & aortic Stenosis), Treatment & Valve Replacement

Heart valves play an essential role in the proper functioning of the heart. There are four valves in the heart - the aortic, pulmonary, tricuspid, and mitral valves. These valves help regulate the flow of blood in and out of the heart, ensuring that blood flows in the right direction and doesn't leak back into the chambers of the heart. However, sometimes these valves can become blocked, leading to a variety of problems.

Two of the most common types of valve blockages are mitral stenosis and aortic stenosis. Mitral stenosis occurs when the mitral valve becomes narrow or stiff, making it difficult for blood to flow through the valve from the left atrium to the left ventricle. Aortic stenosis occurs when the aortic valve becomes narrow or stiff, making it difficult for blood to flow from the left ventricle to the aorta and the rest of the body.

The causes of these blockages can vary, but some common causes include:

Age-related degeneration:

As we age, our body undergoes natural degeneration, and our heart valves are no exception. The heart valves become less flexible and may develop calcium deposits over time, leading to stiffening or narrowing of the valve opening. This condition is known as aortic stenosis, and it can lead to blockages in the valve and reduced blood flow from the heart to the rest of the body. Aortic stenosis is more common in older adults, particularly those over the age of 65.

Congenital heart defects:

Some people are born with heart valve abnormalities, which can cause blockages later in life. For example, a bicuspid aortic valve is a congenital condition where the aortic valve has two leaflets instead of the usual three. This can lead to valve narrowing or leakage, resulting in blockages or reduced blood flow.

Rheumatic fever:

Rheumatic fever is a condition caused by a streptococcal infection that can damage the heart valves. When the immune system attacks the bacteria, it can also mistakenly attack healthy tissues, including the heart valves. The damaged valves can develop scar tissue, leading to narrowing or leakage and, ultimately, blockages.

Infections:

Certain infections, such as endocarditis, can also damage heart valves and lead to blockages. Endocarditis is an infection of the inner lining of the heart, including the heart valves. The infection can cause valve damage, leading to blockages or leakage and reduced blood flow. Endocarditis is more common in people with preexisting heart conditions, such as congenital heart defects or artificial heart valves.

If left untreated, mitral and aortic stenosis can lead to serious complications, such as heart failure, stroke, and even death. Treatment for these conditions typically involves valv replacement surgery. However, before surgery is recommended, a clinical examination and investigation will be conducted to determine the severity of the blockage and the best course of action.

During the clinical examination, a doctor will listen to your heart using a stethoscope to determine if there are any abnormal heart sounds or murmurs. They may also order additional tests, such as an electrocardiogram (ECG) or an echocardiogram, to get a better look at the heart and its valves.

If the blockage is severe, a coronary angiography may be performed to determine if there are any blockages in the coronary arteries. This test involves injecting a special dye into the arteries and taking X-rays to see if there are any narrow or blocked areas. There are two types of surgeries used to replace heart valves - open-heart surgery and minimally invasive surgery. Open-heart surgery involves making a large incision in the chest to access the heart and replace the damaged valve. This type of surgery requires a longer hospital stay and a longer recovery time. Minimally invasive surgery, on the other hand, involves making small incisions in the chest and using specialized instruments to access the heart and replace the valve. This type of surgery typically has a shorter hospital stay and a faster recovery time than open-heart surgery.

In conclusion, heart valve blockages can be serious and require prompt treatment to prevent complications. If you are experiencing symptoms of mitral or aortic stenosis, such as shortness of breath or chest pain, it's important to see a doctor for a clinical examination and investigation. If valve replacement surgery is recommended, talk to your doctor about the two types of surgeries available and which one may be best for you. With proper treatment, most people with heart valve blockages can return to a normal, healthy life.

Dr. Amit Bhushan Sharma

Director & Unit Head – Cardiology

Paras Health, Gurugram