May 27, 2022 Author : Regina Ribeiras Heart valves Heart valves are structures of the heart that ensure that the flow of blood in this organ and to the small and large circulation is made only in one direction : From the atria (or upper chambers of the heart) to the ventricles (lower chambers of the heart); From the left ventricle to the aorta artery (large circulation); From the right ventricle to the pulmonary artery (small circulation). What are the heart valves called and where are they located? The four heart valves—aortic, pulmonary, mitral, and tricuspid—have the following locations: The aortic valve separates the left ventricle from the aorta artery: The pulmonary valve separates the right ventricle from the pulmonary artery; The mitral valve separates the left atrium from the left ventricle; The tricuspid valve separates the right atrium from the right ventricle. Cardiac contraction and movement of blood Heart valves open and close as the heart contracts and relaxes . Cardiac systole is the contraction of the heart and is referred to the ventricles. Cardiac diastole is the relaxation or dilation of the heart and is also referred to the ventricles. Blood enters the heart in the atria from: The pulmonary veins, which are four, to the left atrium; The superior (SVC) and inferior (IVC) vena cava to the right atrium. When the ventricles relax in cardiac diastole : The mitral and tricuspid valves open and blood flows from the atria to the ventricles; The aortic and pulmonic valves close so there is no reflux of blood from the arteries into the relaxed ventricles. When the ventricles contract in cardiac systole : The aortic and pulmonary valves open and blood flows from the left ventricle to the aorta artery and from the right ventricle to the pulmonary artery; The mitral and tricuspid valves close so there is no reflux of blood from the ventricles into the atria. Valvular heart diseases Valvulopathy or valvular heart diseases refer to diseases of one or more heart valves that prevents them from ensuring their proper functions. Most often heart valve diseases are: The inability to open enough for blood to flow properly, in which case there is said to be a stenosis (tightening) of the valve; Failure to close properly to prevent reflux of blood, which is said to be regurgitation or insufficiency . Depending on the valve affected and whether it is stenosis or regurgitation or insufficiency, valvulopathies imply a volume or pressure overload for the heart , with consequences for the cardiovascular system and other body systems. Frequently, valvular diseases cause important alterations in the structure and function of the ventricles, as well as dilatation of the atria. They can also significantly affect the pulmonary circulation and produce pulmonary hypertension. The severity and extent of these changes on other cardiac structures depends on the severity of the valvulopathy but also on the duration of the disease. Therefore, timely diagnosis and treatment is very important . Causes and symptoms of valvular heart disease Valvular heart diseases can have several causes: It may be congenital , ie be present at birth; It may be a complication of an infection , such as endocarditis or rheumatic fever; In Europe, the most frequent cause is valve wear associated with aging , which explains the higher prevalence of these diseases in older ages. It can also be a valvulopathy in previously repaired or replaced with a prosthesis. In many cases, valve diseases are discovered accidentally, without previous symptoms having occurred. When valvular heart diseases causes symptoms , these vary and depend on the valve affected and the severity of the disease. The most common are: Breathing difficulty, especially with exertion; Crises of breathing difficulties at night or in a lying position, requiring to sleep sitting up; Excessive tiredness, dizziness or fainting; Swollen feet and legs; Abdominal pain; Irregularity of heartbeats; Blood pressure changes. Most common valvular heart disease The valves of the left heart – aortic and mitral – are the most affected. The most common valve diseases are: Mitral stenosis Aortic stenosis Regurgitation or aortic insufficiency Regurgitation or mitral regurgitation Regurgitation or tricuspid insufficiency Mitral prolapse Valves previously operated, either by valve repair or with valve prostheses, may suffer valvulopathies again, and therefore require lifelong surveillance. Currently, several treatment options are available for valvular heart disease , from pharmacological treatment to valve replacement, through repair either by cardiac surgery or percutaneously. With an early diagnosis and adequate surveillance , it is possible, in most cases, to successfully treat valvular heart disease and maintain a good quality of life. Meet the cardiology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
