I. Valvular Stenosis: Narrowing, stiffening, thickening,
fusion or blockage of one or more valves of the heart is called valvular
stenosis. The defective valve interferes with smooth passage of blood
through it (1). Various subtypes of valvular stenosis include:
1. Aortic Valve
Stenosis: This is abnormal narrowing of the aortic valve
orifice due to calcification of the aortic valve (3).
2. Mitral Stenosis: This is abnormal narrowing
of the mitral valve orifice usually occurring in people just before
attaining old age (65 years). In this type the mitral valve becomes
severely calcified later in life (4).
3. Tricuspid Stenosis: It is abnormal narrowing
of tricuspid valve orifice due to multivalvular rheumatic heart
disease or the carcinoid syndrome (5).
4. Pulmonary Valve Stenosis: In this condition,
the flow of blood is obstructed at the pulmonary valve which separates
the heart from the pulmonary artery. Generally this condition
occurs in developing stages of unborn babies (fetus). Narrowing
of the pulmonary valve is called pulmonary valve stenosis.
Narrowing below the pulmonary valve is called subvalvar pulmonary
stenosis and above the pulmonary valves is called supravalvar
pulmonary stenosis (6).
II. Valvular Regurgitation: In this
condition, blood leaks the reverse direction due to
improper closing of the hearts valves (1).
Diagnosis is based on the defective valve that includes
the subtypes such as:
1. Acute Aortic Regurgitation: Sudden
retrograde movement of blood through a defective
aortic valve into the left ventricle during a
ventricular diastole leads to acute aortic
2. Chronic Aortic Regurgitation: Gradual
or long-standing retrograde blood flow through an
incompetent aortic valve into the left ventricle
during a ventricular diastole leads to acute aortic
3. Acute Mitral Regurgitation:
Sudden retrograde movement of blood through a
defective mitral valve from the left ventricle to the
left atrium during systole leads to acute mitral
4. Chronic Mitral Regurgitation:
Long-standing retrograde blood flow through a
defective mitral valve from left ventricle to left
atrium during a ventricular with eccentric left
ventricular hypertrophy leads to chronic mitral
5. Tricuspid Regurgitation:
Retrograde movement of blood through an inadequately
closed tricuspid valve from the right ventricle to
right atrium during a ventricular systole is called
tricuspid regurgitation (11).
6. Pulmonary Valve Regurgitation: Retrograde
blood flow into the right ventricle from the
pulmonary artery due to an incompetent pulmonary
valve is called pulmonary valve regurgitation (12).
III. Atresia: This is a condition in
which one of the valves fails to develop properly and is
completely closed at birth. Diagnosis is based on the
affected valve such as:
defective aortic valve.
defective mitral valve.
defective tricuspid valve.
defective atresia (1).
IV. Mitral Valve Prolapse: In this
type the two flaps of mitral that are located between the
left atrium and the left ventricle are unable to close
properly resulting in leakage of blood back into the left
atrium (mitral valve regurgitation). This may be due to
one or both the flaps being too large or because the
muscle hinges of the flaps being too long
V. Fibro-calcific degeneration: The aortic valve leaflets
become calcified (hardened) and fibrotic (thickened) due to factors such
as aging, low body weight and hypertension leading to narrowed valve opening
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