Valvular problems of the heart

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These always need assessing and monitoring by a cardiologist

The heart is a pump to push blood round the body. The muscles of the heart pump rhythmically and the valves of the heart makes sure the blood goes in the right direction. The right side of the heart just pumps the blood around the lung, with the blood returning to the left side. The left side of the heart pumps the blood round the whole of the rest of the body, therefore the left side has to be much stronger than the right side. When the blood returns to the heart it passes into the atria. The atria contract thereby pumping blood through a valve (the mitral valve on the left, tricuspid on the right) into the ventricles. This is the part of the heart which does the real work pumping the blood into the rest of the circulation through another set of valves (aortic on the left, pulmonary on the right). Because the pressures involved are much higher on the left side of the heart, it is nearly always the aortic valve or the mitral valve which have problems.

Interestingly, the heart is only responsible for about 60% of pumping. The rest is done by the muscular arteries which pick up the pulse wave and add in their own pumping action.

The problems are either due to narrowing or leaking of the valve namely:

  • Aortic stenosis (narrowing)
  • Aortic incompetence (leaking)
  • Mitral stenosis (narrowing)
  • Mitral incompetence (leaking)

Valve problems are diagnosed by listening for murmurs. Murmurs are simply the noise made by turbulence of the blood flow, either because the valve is the wrong shape, or the blood leaks back through it. The diagnosis can be confirmed by echocardiogram and/or measuring pressures in the heart through a catheter.

Aortic valve problems

Narrowing or leakage of the aortic valve has to be treated by surgery. I am not aware of any nutritional interventions that will help this significantly. A common cause of aortic stenosis is congenital bicuspid valve (the valve has two cusps instead of three). This problem may run in families so first degree relatives should be screened.

Mitral valve problems

Narrowing of the mitral valve (mitral stenosis) was a common result of rheumatic fever. Thankfully we see less of this these days. By far the most common valvular problem is mitral incompetence, when blood leaks back through the mitral valves. Leakage can occur for two obvious reasons - either the mitral valve is too floppy, or the mitral ring (i.e. that muscular, fibrous structure on to which the mitral valve is attached) becomes too large. By far and away the commonest problem is when the mitral ring stretches so the valves do not meet in the middle. This occurs when the heart dilates, ie the chambers of the heart get bigger when the heart goes into failure - a well recognised effect of heart failure. The trouble is this makes the heart failure much worse as the mitral valve leaks. I suspect this explains why the prognosis for heart failure is so poor.

So mitral incompetence and heart failure often co-exist with one leading to the other.

The treatment is as per Low cardiac output state. The mitochondrial issue is nearly always ignored by cardiologists - this is an aspect that people have to sort out themselves by taking the appropriate supplements. See CFS - The Central Cause: Mitochondrial Failure - you can access a test of Mitochondrial function at AONM Mitochondrial Testing

If there is a valve problem, the heart works inefficiently as a pump, so it has to work harder. This puts a stress on the heart and makes other problems such as poor blood supply to the heart, or poor mitochondrial function in the heart much worse. So too will infarction (i.e. dead areas of heart muscle following a heart attack). So also tackle other problems vis:

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