valvulopathy

Valvulopathy is a broad term for diseases of the heart valves that disrupt their structure or function. It includes conditions that cause stenosis, narrowing of a valve and restricting blood flow, and regurgitation (insufficiency), where a valve fails to close properly and permits backward flow. The mitral and aortic valves are most commonly affected, though disorders of the tricuspid and pulmonary valves also occur.

Common causes include congenital abnormalities, rheumatic heart disease, and degenerative or calcific changes related to aging. Other etiologies are infective endocarditis damage to valve leaflets, ischemic injury affecting the supporting structures, and radiation exposure. Some conditions produce mixed lesions with both stenosis and regurgitation.

Clinical presentation varies with valve involved and disease severity. Symptoms may include shortness of breath, fatigue, chest pain, syncope, and edema, especially with heart failure. On examination, abnormal heart murmurs and signs of altered hemodynamics may be present. The diagnosis relies on imaging and tests, with echocardiography (including Doppler) as the primary tool to quantify severity and valve function. Electrocardiography and chest radiographs provide supporting information, while MRI or CT can aid in planning interventions.

Management aims to relieve symptoms, prevent complications, and correct valve dysfunction. Medical therapy can include diuretics and vasodilators; anticoagulation is used for certain prosthetic valves or atrial fibrillation. Definitive treatment typically involves valve repair or replacement, which can be surgical or via catheter-based approaches such as transcatheter aortic valve replacement (TAVR) or percutaneous mitral repair. Prosthetic valves can be mechanical (durable but requiring anticoagulation) or bioprosthetic (less anticoagulation but limited durability).

Prognosis depends on etiology, severity, and comorbidity. Valvular disease is common in aging populations and requires ongoing assessment and management.