Valve insufficiency is a heart condition that results when a heart valve doesn’t fully close during the heartbeat. This can be minor to severe and its presence affects heart function. If minor valve insufficiency worsens, it may cause signs of congestive heart failure. It’s a condition that cardiologists closely monitor or address with treatment of varying kinds.
There are four heart valves, any of which may express valve insufficiency or incompetence. These valves are the aortic and pulmonary valves, which respectively are attached to the left and right ventricles. The tricuspid valve is located between the right atrium and ventricle, and the mitral valve is the opening and closing passageway between the left atrium and ventricle. One of the primary issues with a poorly functioning valve is that it does not close properly, causing a condition called regurgitation, where blood leaks back into the chamber that just pumped the blood. For example, aortic insufficiency causes blood to leak back into the left ventricle, and mitral valve insufficiency means blood leaks back into the left atrium.
If the volume of blood that flows backward is high, it affects the functioning of the heart chamber that is receiving it in the wrong direction. The chamber can enlarge, have higher than normal pressure, and be less able to function. The area of the heart that should be receiving the blood may suffer from lower than normal pressure, which may also reduce heart function. With significant valve insufficiency, conditions like severe edema in the body or lungs, tiredness, and difficulty breathing can develop as the heart becomes more damaged.
Any one of the valves may suffer from incompetence due to a variety of causes. Some people are born with defects to the valves that cause them not to work well. As people age, the heart valves may be less competent and leak some blood backward. Though rarer now, illnesses like rheumatic fever used to routinely cause damage, especially to the mitral valve, resulting in valve insufficiency.
Treatment strategy for this condition depends much on the severity of regurgitation and assessment of present heart function with tools like echocardiogram, x-ray and catheterization. Many people tolerate mild regurgitation without needing a great deal of medical intervention. If valve insufficiency worsens, doctors might consider medicines that reduce heart workload slightly or that lower pressures. In a number of instances, the condition is threatening enough that catheter interventions with balloon angiography or heart surgery are considered to either repair or replace the damaged valve. These surgeries are common and can be very successful.
One note for people diagnosed with valve insufficiency is that they may require antibiotics before any dental procedures. When the valves function inadequately, they become more vulnerable to a bacterial infection called bacterial endocarditis (BE), which can cause further damage. People need to alert their dentists if they have heart valve trouble and be certain to follow recommendations for BE prophylaxis before even minor dental procedures like cleanings.
