The problem with heart-valve disease

PATIENTS with increasing shortness of breath and palpitations may not necessarily be harbouring significant narrowing of their heart arteries. The problem with such patients could lie with their heart valves, as was the case in three patients discussed here.

Valve disease is less commonly recognised, given that the symptoms are more subtle and usually develop gradually. However, recognising valve disease is important if sudden death is to be prevented.

Mitral valve prolapse

Mr A, in his 40s, had chest pain, increasing shortness of breath on exertion and frequent irregular and fast heart beat.

He was found to have a tear in his left heart valve (the mitral valve or MV), which is located between the left upper and lower heart chambers. A segment of the supporting bands of tissue that anchor the edges of the valve to the heart muscle wall had been torn, resulting in it failing to close properly; the result was that blood was "leaking" back into the left upper chamber when the left lower chamber pumps blood out…