Short notes on the defects in the heart valves and their treatment

Short notes on the defects in the heart valves and their treatment

The valves in the heart regulate proper flow of the blood in specific direc­tions. A healthy valve is necessary to perform these functions. But in a number of cases, defects occur in the valves either due to infection or due to congenital (along with the birth) problems. The following are the basic defects in the valves. These are-Mitral stenosis, Mitral incompetence, Aortic stenosis, Aortic incompetence, Tricuspid incompetence, Pulmonary stenosis and Pulmonary incompetence.

Among the infections that bring about the defects in the valves endocarditis and rheumatic fever are the most important. Rheumatic fever is caused by an autoimmune phenomenon following throat infection with betahaemolytic streptococci.

Mitral stenosis:

If for some reason the valves are inflammated the valve leaflets fuse together causing obstruction of blood flow. Mitral stenosis is the usual aftermath of a rheumatic heart disease. In Mitral stenosis there is obstruction to forward flow of the blood. The normal circumference of the Mitral opening is 10 m. Anything less than 7 m is regarded as a block. As a result of block the left atrium dilates and pressure in the pulmonary vein increases. Cardiac output is decreased. The valves are thickTened, distorted and often heavily calcified.

Mitral incompetence ( Mitral regurgitation): In Mitral incompetence the valves do not get closed completely as a result there is back flow of blood from left ventricle into left atrium during ventricular systole. The back flow of blood passes across the Mitral valve again into to left ven­tricle during diastole. As a result the work of left ventricle is increased and it gets dialeted.

Aortic stenosis:

This is caused by calcification of aorta or endocardities or due to congenital defects. As a result of the block the forward flow is decreased and the pulse is weak.

Aortic incompetence (Aortic regurgitation): In this the ejected blood from aorta leaks back into left ventricle hence, left ventricle has to handle more quantity of blood and gets dilated.

Tricuspid stenosis:

This causes dialatation of right atrium and high right auricular pressure. This high pressure results in dilatation of the right auricle. In some instances it may lead to right heart failure.

Tricuspid incompetence:

Insufficiency of tricuspid valve is caused due to dilatation of valve ring and may occur after mitral stenosis. Sometimes it may occur as an after effect of rheumatic fever. Tricuspid incompetence results in right auricular dilatation and right heart failure.

Pulmonary stenosis:

This is caused by congenital defects, rheumatic fever or it may be associated with Fallot’s tetralogy. As a result of pulmo­nary stenosis there is right ventricular hypertrophy.

Pulmonary incompetence:

Pulmonary incompetence may be due to mitral stenosis and may be due to conginetal defects also. Effects of pul­monary incompetence include right ventricular hypertrophy with dilata­tion of its cavity.