The Heart and its Valves

Your heart is a pump that works non-stop to supply both nutrients and oxygen to all the living cells of the body. The normal heart has four chambers and four valves forming two pumps side by side. The upper chambers are called the atria and the lower chambers are called the ventricles. The ventricles are the actual pumping chambers. Blood flow from the atrium to the ventricle and out of the ventricle is controlled by the heart valves, which are one-way valves. That is, they allow blood to flow only in one direction.

Blood returning to the heart from different parts of the body after delivering oxygen and picking up carbon-dioxide is received in the right atrium and delivered to the right ventricle through the TRICUSPID valve. It is pumped into the lungs through the PULMONARY valve. After removal of carbon-dioxide and picking up oxygen in the lungs, the oxygenated blood is received in the left atrium from where it flows into the left ventricle through the MITRAL valve. It is pumped out to the entire body through the AORTIC valve.

Defects and Diseases of heart valves

One of the main causes of defective valves is rheumatic heart disease. Congenital defects can also cause malfunctioning of the heart valves. Coronary Artery disease can sometimes cause valve problems. When this happens it may result in one of the two conditions. In one, called STENOSIS, the valve does not open fully preventing the normal flow of blood through it. In the other, called REGURGITATION, the valve does not close fully allowing blood to leak back through it.

When you have a heart problem the heart may make an abnormal sound. This is called MURMUR. Your Doctor would form his own conclusions on the murmur by additional tests, which may be needed to determine your problem.

These tests may be one or more of the following:

Your Doctor might have put you on medications for treating your valve problem.

After various tests he may recommend a valve surgery. Depending on your specific problems one or more valves may need attention. During surgery your Doctor may either attempt to repair the defects or replace the defective valve or valves.

The extra boost your heart may get after surgery will make you feel better. You will feel improvement in your symptoms, which you were experiencing before surgery.

Since you feel better you can gradually start doing things that you enjoy doing. You will have to take care of yourself and your heart so that the new valve will continue to function well.

Your Doctor will advise you on what you should do to keep your heart valves functioning properly in future. He will prescribe you a medication called ANTICOAGULANTS, which you should take, daily. He may also recommend some tests to adjust the dose of medication at intervals.

Before you get discharged from the hospital your Doctor would have told you under what conditions you should refer back to him. You can make a list of his suggestions and refer to them during your next visit.

Be aware of the following and consult your Doctor if these manifest.

• One of the signs of internal bleeding can be black stools or dark or blood-containing urine.
• Since you are on anticoagulants you may find bruises or bleeding which cannot be related to any injury. An accidental injury or cut may lead to uncontrolled bleeding.
• The rhythm of your heart might change. It may become faster, slower or irregular.
• You may catch a cold, flu or other infection. You may develop fever/chills lasting longer than a day. Your incision may swell, remain red, and ooze blood or serum. You may also feel pain in your chest when you take a deep breath or when you cough or sneeze.
• It is possible that your sense of well-being and recovery may result in a gain in weight. But watch out for excessive gain in weight more than two kilos a week.

These signs should not alarm you but tune you to listen to what your body is telling you and make you act sensibly.

It is important to maintain a record of the current dose of the anticoagulant and the PROTHROMBIN TIME if you are on anticoagulant therapy.

Have a small card indicating that you have an artificial heart valve, its position (Aortic, Mitral or both). It would also help if you keep the name of the hospital and the in-patient ID given to you when your valve operation was done. Always carry this card with you.

Carrying a card like this would protect you if unfortunately you are involved in an accident or have a fainting spell in an unfamiliar place.

If you are a woman and are consulting with a gynaecologist, be sure to give all the details of your medications.