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The heart is a muscle that acts as a pump.  It has four chambers: the left atrium, the right atrium and the left and right ventricles.

There are four valves in the heart.  These valves guard the exits of all four heart chambers to make sure that the blood cannot leak backwards and that it flows onward in the correct direction.

Kalliopi First Aid Training - Heart Health - Heart Valve Disease - Heart Valves

A diseased or damaged valve can affect the flow of blood in two ways:

If the valve doesn’t open fully or becomes stiff, it can obstruct the flow of blood.  This is called valve stenosis. (A stenosed valve means a valve that has become stiff and therefore narrow, causing an obstruction to the flow of blood).  If the valve does not close properly, it will allow blood to leak backwards.  This is called regurgitation or valve incompetence.

Both stenosis and regurgitation can put an extra strain on the heart.  If you have stenosis, the valve can obstruct the flow of blood, so your heart will have to pump harder to force the blood past the obstruction.  If you have regurgitation, your heart has to do extra work to pump enough blood forwards against the blood flowing backwards through the leaking valve.

As well as your heart having to work harder, the blood behind the affected valve will be under increased pressure, which is called back pressure.  This can result in a build-up of fluid either in your lungs or in your ankles or legs, depending on which valve is affected.

What are the symptoms of heart valve disease?

The symptoms of heart valve disease vary, depending on which valve is affected and to what extent it is affected.  People with mild heart valve disease may not notice any symptoms or may have very few symptoms.  However, increasing strain on the heart caused by heart valve disease can cause you to become tired easily, or cause pounding in the chest otherwise known as heart palpitations.  The back pressure can cause a build-up of fluid in the lungs which can lead to shortness of breath, and/or swelling in the ankles and legs.  Due to the forward flow of blood being severely obstructed, the person may feel dizzy or even faint because less blood is reaching the brain.  People with heart valve disease may experience chest pain, due to not enough blood flowing through the coronary arteries, the arteries that supply oxygen rich blood to the heart muscle.

Diagnosis of heart valve disease and abnormalities of the heart valves are often picked up during routine examination with a stethoscope by listening for a murmur.  Whilst some murmurs are completely normal, the doctor will be able to tell if you need further tests, depending on what type of murmur he or she hears.

If you do have a murmur which is suspicious, you will undergo several tests:

An electrocardiogram (ECG) which records the rhythm and electrical activity of your heart

A chest x-ray, and

An echocardiogram which produces an ultrasound picture of the heart and valves.

Another test which exists is the cardiac catheterisation, otherwise known as coronary angiogram.  This test provides important information about the condition of the heart.  A catheter (a long plastic tube) is passed into the artery in the groin or arm, and using x-ray screening, the catheter is directed through the blood vessels and into the hart.  A special dye is then injected and a series of x-ray pictures which makes all the coronary arteries appear on the x-rays.

The coronary angiogram test can also find out how good the blood supply to your heart muscle is, and whether there is any narrowing of your coronary arteries.  If the blood supply is not good, and if you need valve surgery, the doctors may do both the valve surgery and bypass surgery (to improve the blood supply to the heart muscle) at the same time.

What causes heart valve disease?

Being born with an abnormal valve or valves (congenital heart disease)

Rheumatic fever

Ageing of the heart

Cardiomyopathy

Coronary heart disease, or

a previous infection with endocarditis

Congenital heart disease - Some people are born with an abnormal valve or valves.  Fortunately, most of these people never experience any symptoms.  However, in some people the condition can get worse over the years, causing stenosis or regurgitation, or both.

Rheumatic fever - A very small number of people still get rheumatic fever.  Some can be affected as children, but develop symptoms of heart valve disease as adults.  Rheumatic fever can affect one, two or three valves, causing stenosis or regurgitation or both.  The most commonly affected valves are the aortic and mitral valves.

Ageing of the heart - As we age, the heart valves, the aortic valve in particular, may thicken as a result of wear and tear, or uncontrolled high blood pressure.  This means that the space through which the blood flows becomes narrower.  How sever this narrowing is can determine how sever the symptoms are.  The aortic valve can become stiffer as calcium deposits from the blood settle on it, causing it to harden. In many people this doesn’t cause a problem, but others may get symptoms.

Cardiomyopathy - Cardiomyopathy is a disease of the heart muscle.  Sometimes this disease causes the heart not to contract properly because the muscle has become stretched.  This may cause problems with one or more valves.  The most common problem is that the mitral valve opening has become stretched and it can no longer close properly.

Coronary heart disease - In people with coronary heart disease, the heart muscle does not always get a good supply of blood.  This can make the heart muscle pump less efficiently and cause the mitral valve to leak because i has become floppy.

A previous infection with endocarditis - Endocarditis is an infection of the lining of the heart.  If you have previously had endocarditis, this may have damaged one of the heart valves, meaning at some stage you may require the affected valve to be replaced or repaired.

Treatment for heart valve disease

Regular echocardiograms are important for those of us suffering with heart valve disease.  The decision on what sort of treatment you need will depend on which valve, how badly it is affected, how many are affected and how badly the heart’s ventricles are affected, your symptoms and your general health.

The main options include medicines, valve surgery, which may involve replacing or repairing the valve,  a procedure called transcatheter aortic valve implantation or a procedure called percutaneous mitral valve leaflet repair, valvuloplasty or a combination of medicines with either surgery or one of these procedures.

Medicines commonly used for people with heart valve disease include diuretics, ACE inhibitors and digoxin.

Diuretics encourage the body to produce urine and can relieve the build-up of fluid in the lungs and in the ankles and legs.

ACE inhibitors reduce the amount of work the heart has to do.

Digoxin slows the heart rate, stabilises the heart rhythm and helps the heart’s pumping action.

You may also be required to take anticoagulants – medicines that change the clotting mechanism of the blood, to reduce the chances of a clot forming.  The most common anticoagulant is called warfarin.

 

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Kalliopi First Aid Training © – Ioakim & Ioakim Ltd

What We Offer:

“Approved First Aid Training Courses in Cyprus” We offer approved, First Aid at Work First Aid Training Courses in Cyprus including: Emergency First Aid at Work; First Aid at Work; Automated External Defibrillator and Pool Lifeguard.  Basic Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) training is made according to current guidelines of the European Resuscitation Council (ERC) guidelines 2015. Training Certificates are issued under the provisions of the Health & Safety at Work (First Aid) Regulations 2009 (PI 198/2009).   We also offer a range of DAN Europe (Divers Alert Network) first aid courses for the scuba diving community through our sister company Kalliopi Dive College.  Visit the dedicated scuba diving in Paphos website: www.dive-college.com.cyfor full details and DAN course programmes.

Our experienced, multi-lingua (Greek, English, German), faculty instructors are certified by the Human Resources Development Authority (HRDA / ΑΝΑΔ / EEK) under its recently revised teaching specifications (2014) to provide grant-aided, subsidised educational seminars.

 

Kalliopi First Aid Training © – Ioakim & Ioakim Ltd

Who We Are

A First Aid Training Centre managed and operated by Ioakim & Ioakim Ltd with over 32 years

experience.  Kalliopi First Aid Training is a member of AOFA (Association of First Aiders).  

We offer a full range of First Aid Certifications and First Aid Training Courses in Cyprus and Greece.  

Kalliopi First Aid Training’s parent company, Ioakim & Ioakim Ltd, is certified by the Ministry Department of Labour & Social Insurance to provide First Aid Training Courses and issue Certifications

under the provisions of the Safety and Health at Work (First Aid) Regulations 2009 (C.D.P.198 / 2009).

Kalliopi First Aid Training © – Ioakim & Ioakim Ltd

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