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Valvular Heart Disease
Treatment options for valvular heart disease include:
I. Medications: Medications do not rectify the valves but treat the complications and reduce the consequences. Medications cannot make up the mechanical problems due to narrowing of valves especially in stenotic cases which essentially require surgery. Medications are generally effective in valvular regurgitation cases.
1. Angiotensin Converting Enzyme (ACE) Inhibitors: These are used to widen blood vessels, lower blood pressure and decrease the workload on heart (in valvular regurgitation).
2. Antiarrhythmics: These maintain a regular heartbeat and reduce the rapid heart rhythms. Thus, the heart beats less frequently but pumps blood more throughout the body (1).
3. Anticoagulants: Valvular problems can lead to blood clots. Anticoagulants help prevent clot formation inside the heart chambers or on a damaged heart valve.
8. Calcium Channel Blockers: These drugs affect the contraction of muscle tissue in heart. By reducing the blood pressure and workload on an affected heart, the calcium channel blockers may postpone surgery.
9. Digitalis: Digitalis is prescribed for treatment of arrhythmias, particularly atrial fibrillation. This drug increases the force of the heart muscles contraction and is helpful if a person has suffered congestive heart failure.
10. Diuretics: These drugs help the body rid of excess fluid and salt. Diuretics also reduce swelling and ease the workload on heart (2).
II. Procedures: When medications are not successful or valve condition worsens, a interventional procedure and/or surgery is performed.
Percutaneous Balloon Valvuloplasty: This is a nonsurgical catheter based procedure to treat valvular stenosis. In this procedure, a catheter is threaded up to the heart through an artery in the groin and guided through the narrowed valve. At the point of narrowed valve, the balloon is gently inflated to stretch the valve. Once the valve is widened, the balloon is deflated and removed.
Valvulotomy: This is an open heart surgery in which the surgeon cuts in to repair the damaged valve. One such surgery is commissurotomy used to rectify mitral stenosis. In this procedure the narrowed valve leaflets are widened by opening the fused leaflets or commissures with a scalpel.
If the valves cannot be repaired then an open heart surgery is performed to replace the defective valve with biological or mechanical valve.
Valvular Heart Disease can be prevented by the following:
1. Prompt treatment of a sore throat that is accompanied with fever and lasts for more than 48 hours. Timely intervention and administration of antibiotics can prevent rheumatic fever that could cause a valvular heart disease.
2. Avoid smoking
3. Avoid alcohol
4. Eating a healthy, balanced low salt and fat diet.
5. Regular physical exercise.
6. Adhering to proper medication if being treated for a heart ailment.
7. Maintaining proper blood sugar levels in case of diabetics.
8. Controlling hypertension (22).
Article by Kona Vishnu, MS
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